Provider Demographics
NPI:1174863468
Name:HARVEY, REBECCA DAWN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:DAWN
Last Name:HARVEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3841 FRANKLIN DEPOT RD
Mailing Address - Street 2:
Mailing Address - City:SIDNEY CENTER
Mailing Address - State:NY
Mailing Address - Zip Code:13839-1225
Mailing Address - Country:US
Mailing Address - Phone:607-829-2882
Mailing Address - Fax:
Practice Address - Street 1:3841 FRANKLIN DEPOT RD
Practice Address - Street 2:
Practice Address - City:SIDNEY CENTER
Practice Address - State:NY
Practice Address - Zip Code:13839-1225
Practice Address - Country:US
Practice Address - Phone:607-829-2882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296788-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse