Provider Demographics
NPI:1043428956
Name:HARVEY, LORETTA (PA-C, RD)
Entity Type:Individual
Prefix:
First Name:LORETTA
Middle Name:
Last Name:HARVEY
Suffix:
Gender:F
Credentials:PA-C, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 MAYBERRY LN
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-2762
Mailing Address - Country:US
Mailing Address - Phone:410-371-0887
Mailing Address - Fax:
Practice Address - Street 1:4315 LONDONDERRY RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5318
Practice Address - Country:US
Practice Address - Phone:717-909-0290
Practice Address - Fax:717-909-0292
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058395363A00000X
PAOA003974363A00000X
PADN005131133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered