Individual provider Active NPI

Aundryea Harlan

  • Licensed Practical Nurse
  • Newark, OH
National Provider Identifier
1164823506
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN. 128276 Issued in OH
Practice address
373 N 11TH St
Newark, OH 43055-4421
Phone
(740) 281-0908
NPI assigned
Sep 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN. 128276 OH Primary

Addresses

Primary practice location

373 N 11TH St
Newark, OH 43055-4421

Mailing address

373 N 11TH St
Newark, OH 43055-4421
Phone (740) 281-0908

Other identifiers 1

IdentifierTypeStateIssuer
2958081MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN. 128276OHMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1164823506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 N 11TH ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430554421",
            "telephone_number": "740-281-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 N 11TH ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430554421",
            "telephone_number": "740-281-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARLAN",
        "first_name": "AUNDRYEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN. 128276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2958081",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.