Provider Demographics
NPI:1376115782
Name:HARVEY, STEFANY KRISTINE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:STEFANY
Middle Name:KRISTINE
Last Name:HARVEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 BOULDER LN
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-7002
Mailing Address - Country:US
Mailing Address - Phone:936-590-0636
Mailing Address - Fax:
Practice Address - Street 1:4909 NORTH ST STE 202
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1808
Practice Address - Country:US
Practice Address - Phone:936-590-0636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1021095363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily