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Individual

MATTHEW DUANE HARMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
250 PARK ST, BOWLING GREEN, KY 42101-1760
(270) 393-1912
(270) 393-1913
Mailing address
165 NATCHEZ TRACE AVE STE 205, BOWLING GREEN, KY 42103-7947
(270) 393-1912
(270) 393-1913

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3011691
KY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1132791
RN LICENSE
KY
01
3011691
APRN
KY
Enumeration date
08/07/2017
Last updated
09/05/2017
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