Provider Demographics
NPI:1649363276
Name:HARMON, DONALD LEE (PA)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:LEE
Last Name:HARMON
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 GRANT STREET
Mailing Address - Street 2:
Mailing Address - City:BEATRICE
Mailing Address - State:NE
Mailing Address - Zip Code:68310
Mailing Address - Country:US
Mailing Address - Phone:402-228-4455
Mailing Address - Fax:402-645-3397
Practice Address - Street 1:116 EAST H STREET
Practice Address - Street 2:
Practice Address - City:WYMORE
Practice Address - State:NE
Practice Address - Zip Code:68466
Practice Address - Country:US
Practice Address - Phone:402-645-3310
Practice Address - Fax:402-645-3397
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE367363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NER81930Medicare UPIN