Provider Demographics
NPI:1457483778
Name:HARVISON, EMILY (NP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:HARVISON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 ROCK SPRINGS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6108
Mailing Address - Country:US
Mailing Address - Phone:615-459-5252
Mailing Address - Fax:615-459-5232
Practice Address - Street 1:238 CENTRE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:PLEASANT VIEW
Practice Address - State:TN
Practice Address - Zip Code:37146-7060
Practice Address - Country:US
Practice Address - Phone:615-746-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN140150163WP0200X
TNAPN11794363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5441708Medicaid
TN3341166Medicare PIN