Basic Information
Provider Information
NPI: 1356318364
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARMON
FirstName: ESTHER
MiddleName: LAVERNE D.
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 856 J CLYDE MORRIS BLVD
Address2: SUITE A
City: NEWPORT NEWS
State: VA
PostalCode: 236011318
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1500 COMMONWEALTH AVE
Address2:  
City: WILLIAMSBURG
State: VA
PostalCode: 231855229
CountryCode: US
TelephoneNumber: 7575852250
FaxNumber: 7575852061
Other Information
ProviderEnumerationDate: 03/08/2006
LastUpdateDate: 12/18/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X0024066143VAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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