Provider Demographics
NPI:1558507350
Name:HARVEY, LAURIE B (RNFA, CNDR, RN)
Entity type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:B
Last Name:HARVEY
Suffix:
Gender:F
Credentials:RNFA, CNDR, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1289
Mailing Address - Street 2:
Mailing Address - City:VARNVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29944
Mailing Address - Country:US
Mailing Address - Phone:803-943-4003
Mailing Address - Fax:803-943-4701
Practice Address - Street 1:408 JACKSON AVE E
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:SC
Practice Address - Zip Code:29924
Practice Address - Country:US
Practice Address - Phone:803-943-4003
Practice Address - Fax:803-943-4701
Is Sole Proprietor?:No
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC53770163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant