Harless, Anne G W

Harless, Anne G W is an individual health care provider with primary practice located at 3512 Stellhorn Rd , Fort Wayne IN 46815-4631. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Harless, Anne G W can be contacted via phone (260) 483-9081.

Contact Information

Primary practice address
3512 Stellhorn Rd Fort Wayne IN 46815-4631
Phone: (260) 483-9081
Fax: (260) 483-9196
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 364SA2200X 71006721A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 71006721A Indiana

Profile Details

NPI number 1174073373
LBN Legal business name Harless, Anne G W
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2016
Last updated Mar 16th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174073373 NPPES
Indiana MEDICAID 201405200
Indiana Other P01751331

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