Provider Demographics
NPI:1508466368
Name:HARVEY, AMALIA JO FOLLAND (NP)
Entity Type:Individual
Prefix:
First Name:AMALIA
Middle Name:JO FOLLAND
Last Name:HARVEY
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 1:19883 EVENSONG CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55024-8688
Mailing Address - Country:US
Mailing Address - Phone:651-246-1771
Mailing Address - Fax:
Practice Address - Street 1:19883 EVENSONG CT
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55024-8688
Practice Address - Country:US
Practice Address - Phone:651-246-1771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7704363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily