Provider Demographics
NPI:1811473481
Name:HARVEY, ADRIANE WRIGHT (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ADRIANE
Middle Name:WRIGHT
Last Name:HARVEY
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1059 RIDGEWOOD PL
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-2018
Mailing Address - Country:US
Mailing Address - Phone:601-957-3211
Mailing Address - Fax:
Practice Address - Street 1:1059 RIDGEWOOD PL
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-2018
Practice Address - Country:US
Practice Address - Phone:601-957-3211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902586363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health