Provider Demographics
NPI:1598482721
Name:HARSHMAN, IVANNA (CPNP-PC, PMHS)
Entity type:Individual
Prefix:DR
First Name:IVANNA
Middle Name:
Last Name:HARSHMAN
Suffix:
Gender:F
Credentials:CPNP-PC, PMHS
Other - Prefix:MS
Other - First Name:IVANNA
Other - Middle Name:
Other - Last Name:BUCHYNSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6655 SANTA BARBARA RD
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-7500
Mailing Address - Country:US
Mailing Address - Phone:866-968-6342
Mailing Address - Fax:
Practice Address - Street 1:6655 SANTA BARBARA RD
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-7500
Practice Address - Country:US
Practice Address - Phone:866-968-6342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-27
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR233624363LP0200X
MD20259383364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD119591300Medicaid