Provider Demographics
NPI:1821355637
Name:HARVEY, KEISHA D'ANDREA (MD)
Entity Type:Individual
Prefix:DR
First Name:KEISHA
Middle Name:D'ANDREA
Last Name:HARVEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2781 S COLUMBIA ST
Mailing Address - Street 2:STE A
Mailing Address - City:BOGALUSA
Mailing Address - State:LA
Mailing Address - Zip Code:70427-7962
Mailing Address - Country:US
Mailing Address - Phone:229-869-0294
Mailing Address - Fax:
Practice Address - Street 1:70124 3RD ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-8407
Practice Address - Country:US
Practice Address - Phone:229-869-0294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.206754207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine