Provider Demographics
NPI:1538461033
Name:HARVEY, NINA RENEE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:NINA
Middle Name:RENEE
Last Name:HARVEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2648
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35202-2648
Mailing Address - Country:US
Mailing Address - Phone:205-930-1175
Mailing Address - Fax:205-930-1189
Practice Address - Street 1:1400 6TH AVENUE SOUTH
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1502
Practice Address - Country:US
Practice Address - Phone:205-930-1175
Practice Address - Fax:205-930-1189
Is Sole Proprietor?:No
Enumeration Date:2010-12-03
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1124155363L00000X
OH12384NP363LF0000X
KYF1110115363LF0000X
AL1-109547363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL307300000Medicaid
OHCOA.1284-NPOtherOHIO LICENSE
AL1-109547OtherALABAMA BON