Individual provider Active NPI

Marie C Harlan-Ivy, ARNP

  • Nurse Practitioner
  • Yakima, WA
National Provider Identifier
1306854492
Registry record updated Jan 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP30003719 Issued in WA
Practice address
2501 Business LN
Yakima, WA 98901-1167
Phone
(509) 575-4800
Fax
(509) 573-3400
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP30003719 WA Primary

Addresses

Primary practice location

2501 Business LN
Yakima, WA 98901-1167

Mailing address

732 Summitview Ave
#621
Yakima, WA 98902-3032
Phone (509) 573-3448

Other identifiers 1

IdentifierTypeStateIssuer
9625369MedicaidWA

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)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231459200000",
    "number": "1306854492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 SUMMITVIEW AVE",
            "address_2": "#621",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023032",
            "telephone_number": "509-573-3448",
            "fax_number": "509-574-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 BUSINESS LN",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989011167",
            "telephone_number": "509-575-4800",
            "fax_number": "509-573-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARLAN-IVY",
        "first_name": "MARIE",
        "middle_name": "C",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2009-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30003719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9625369",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2009; 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.