Provider Demographics
NPI:1144976556
Name:HARVEY, KIRA
Entity type:Individual
Prefix:
First Name:KIRA
Middle Name:
Last Name:HARVEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KIRA
Other - Middle Name:
Other - Last Name:CORNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4757 ROUTE 152 STE 2
Mailing Address - Street 2:
Mailing Address - City:LAVALETTE
Mailing Address - State:WV
Mailing Address - Zip Code:25535-9638
Mailing Address - Country:US
Mailing Address - Phone:304-522-1945
Mailing Address - Fax:
Practice Address - Street 1:4757 ROUTE 152 STE 2
Practice Address - Street 2:
Practice Address - City:LAVALETTE
Practice Address - State:WV
Practice Address - Zip Code:25535-9638
Practice Address - Country:US
Practice Address - Phone:304-522-1945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant