Provider Demographics
NPI:1053418194
Name:HARBERT, JOANNE M (ARNP)
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:M
Last Name:HARBERT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6697 NE 12TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:IA
Mailing Address - Zip Code:50237
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:107 N WALNUT ST
Practice Address - Street 2:COLFAX HEALTH SERVICES
Practice Address - City:COLFAX
Practice Address - State:IA
Practice Address - Zip Code:50054
Practice Address - Country:US
Practice Address - Phone:515-674-4186
Practice Address - Fax:515-674-4180
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA093359363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA29038OtherWELLMARK
IAI18650Medicare ID - Type Unspecified
Q73530Medicare UPIN