1750367918 NPI number — MRS. JANIS W HARVEY C FNP

Table of content: MRS. JANIS W HARVEY C FNP (NPI 1750367918)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750367918 NPI number — MRS. JANIS W HARVEY C FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARVEY
Provider First Name:
JANIS
Provider Middle Name:
W
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
C FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750367918
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/21/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 421718
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GEORGETOWN
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29442-4203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-527-7000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
701 S MORGAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANDREWS
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29510-2959
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-264-5253
Provider Business Practice Location Address Fax Number:
843-264-5970
Provider Enumeration Date:
12/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  APN 794 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: RHC068 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: GP1371 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com