Provider Demographics
NPI:1881239903
Name:HARVEY, SHARON GLORIA
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:GLORIA
Last Name:HARVEY
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 1:780 PILOT HOUSE DR.
Mailing Address - Street 2:BUILDING 300 SUITE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-1993
Mailing Address - Country:US
Mailing Address - Phone:757-586-5927
Mailing Address - Fax:866-561-2158
Practice Address - Street 1:780 PILOT HOUSE DR.
Practice Address - Street 2:BUILDING 300 SUITE A
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-1993
Practice Address - Country:US
Practice Address - Phone:757-586-5927
Practice Address - Fax:866-561-2158
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-12
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001194083364SP0810X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0810XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Family
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA3001750153000Medicaid