Provider Demographics
NPI:1710171707
Name:HARMON, LOLITA IZETT (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:LOLITA
Middle Name:IZETT
Last Name:HARMON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6451 ARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-3122
Mailing Address - Country:US
Mailing Address - Phone:269-208-3356
Mailing Address - Fax:
Practice Address - Street 1:1619 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46404-1506
Practice Address - Country:US
Practice Address - Phone:219-886-4788
Practice Address - Fax:219-886-4106
Is Sole Proprietor?:No
Enumeration Date:2007-09-01
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN142204163WE0003X
IN71010570A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency