Provider Demographics
NPI:1699348292
Name:HARVEY, KIMBERLINA TIFFINY (AGACNP)
Entity type:Individual
Prefix:
First Name:KIMBERLINA
Middle Name:TIFFINY
Last Name:HARVEY
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 VISTA LN
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-4643
Mailing Address - Country:US
Mailing Address - Phone:775-301-9537
Mailing Address - Fax:
Practice Address - Street 1:1470 MEDICAL PKWY STE 160
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-4636
Practice Address - Country:US
Practice Address - Phone:775-301-9537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV844824363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care