Provider Demographics
NPI:1811692213
Name:HARBERT, OLIVIA VICTORIA ABIGAIL
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:VICTORIA ABIGAIL
Last Name:HARBERT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 1/2 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-3650
Mailing Address - Country:US
Mailing Address - Phone:681-404-9914
Mailing Address - Fax:
Practice Address - Street 1:911 1/2 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-3650
Practice Address - Country:US
Practice Address - Phone:681-404-9914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant