Provider Demographics
NPI:1962757302
Name:HARVEY, JEMETTA S (RN, FNP)
Entity type:Individual
Prefix:
First Name:JEMETTA
Middle Name:S
Last Name:HARVEY
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4645 AUGUSTA RD
Mailing Address - Street 2:
Mailing Address - City:BEECH ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29842-7265
Mailing Address - Country:US
Mailing Address - Phone:803-593-9283
Mailing Address - Fax:803-593-0607
Practice Address - Street 1:4645 AUGUSTA RD
Practice Address - Street 2:
Practice Address - City:BEECH ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29842-7265
Practice Address - Country:US
Practice Address - Phone:803-593-9283
Practice Address - Fax:803-593-0607
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17928363L00000X, 364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health