Basic Information
Provider Information
NPI: 1003141623
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARVEY
FirstName: DEBRA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 101 E OLNEY AVE
Address2: SUITE 400
City: PHILADELPHIA
State: PA
PostalCode: 191202421
CountryCode: US
TelephoneNumber: 2152542630
FaxNumber: 2152542599
Practice Location
Address1: 295 BUCK RD
Address2: SUITE 105
City: HOLLAND
State: PA
PostalCode: 189661733
CountryCode: US
TelephoneNumber: 2153221919
FaxNumber: 2153222875
Other Information
ProviderEnumerationDate: 10/15/2009
LastUpdateDate: 10/15/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200XSO003153DPAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


Home