Provider Demographics
NPI:1194288308
Name:HARVEY, MARNI KREHNBRINK (MD)
Entity type:Individual
Prefix:DR
First Name:MARNI
Middle Name:KREHNBRINK
Last Name:HARVEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARNI
Other - Middle Name:ANN
Other - Last Name:KRENBRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1401 MATTHEWS TOWNSHIP PKWY STE 100
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5403
Practice Address - Country:US
Practice Address - Phone:704-384-1080
Practice Address - Fax:704-384-1122
Is Sole Proprietor?:No
Enumeration Date:2019-04-14
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC307880208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program