MEDICARE: DR. NINA RENEE HARVEY CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	1124155	KY
2	363LF0000X	Family Nurse Practitioner	12384NP	OH
3	363LF0000X	Family Nurse Practitioner	F1110115	KY
4	363LF0000X	Family Nurse Practitioner	1-109547	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	COA.1284-NP	OTHER	OH	OHIO LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1-109547	OTHER	AL	ALABAMA BON

General Provider Information

NPI Number	:	1538461033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NINA RENEE HARVEY CRNP

Provider Business Mailing Address
First Line	:	PO BOX 2648
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35202-2648
Country	:	US
Telephone Number	:	205-930-1175
Fax Number	:	205-930-1189

Provider Business Practice Location Address
First Line	:	1960 GADSDEN HWY STE 108
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35235-4201
Country	:	US
Telephone Number	:	205-655-1016
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2010
Last Update Date	:	12/16/2024

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