Provider Demographics
NPI:1639417314
Name:HARVEY, JANELLE KATHLEEN (NP)
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:KATHLEEN
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 1:5730 OGEECHEE RD
Mailing Address - Street 2:SUITE 192
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-9521
Mailing Address - Country:US
Mailing Address - Phone:912-201-1140
Mailing Address - Fax:
Practice Address - Street 1:5730 OGEECHEE RD
Practice Address - Street 2:SUITE 192
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-9521
Practice Address - Country:US
Practice Address - Phone:912-201-1140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4775363L00000X
AZRN158105163W00000X
GARN261421363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse