Kaylene Ann Harms, D.D.S.
Individual provider Active NPI Dentist · Crawford, NE
NPI 1194011015 · NPPES record last updated Jun 20, 2011
Key facts
- NPI
- 1194011015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 6962 (NE)
- Practice address
- 705 1St St
Crawford, NE 69339-1186 - Phone
- (402) 640-4521
- NPI assigned
- Jun 20, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150611001904 | NE | Order and Referring Only - Dentist |
2466773718 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6962 | NE | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6962 | NE | Yes |
Addresses
Primary practice location
705 1St St
Crawford, NE 69339-1186
Mailing address
705 1St St
Crawford, NE 69339-1186
Phone (402) 640-4521
Other providers in Crawford, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.