Provider Demographics
NPI:1285162453
Name:HARVEY, ASHLEY VANCE (FNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:VANCE
Last Name:HARVEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 E BRINKLEY LOOP APT 7
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:AR
Mailing Address - Zip Code:72364-5068
Mailing Address - Country:US
Mailing Address - Phone:662-542-7255
Mailing Address - Fax:
Practice Address - Street 1:1605 2ND ST
Practice Address - Street 2:
Practice Address - City:EARLE
Practice Address - State:AR
Practice Address - Zip Code:72331-1634
Practice Address - Country:US
Practice Address - Phone:870-792-8825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902027363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily