Provider Demographics
NPI:1831568666
Name:FOX, HARLEY NELSON (ACNP-BC)
Entity type:Individual
Prefix:MR
First Name:HARLEY
Middle Name:NELSON
Last Name:FOX
Suffix:
Gender:M
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 ROSEANNE CIR
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-7826
Mailing Address - Country:US
Mailing Address - Phone:724-205-0452
Mailing Address - Fax:
Practice Address - Street 1:35 ROSEANNE CIR
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-7826
Practice Address - Country:US
Practice Address - Phone:724-205-0452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007024M363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care