Healthcare Provider Details

I. General information

NPI: 1962409334
Provider Name (Legal Business Name): LISA D HARVEY ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 02/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4419 N HIGHWAY 7
HOT SPRINGS AR
71909-9301
US

IV. Provider business mailing address

PO BOX 21850
HOT SPRINGS AR
71903-1850
US

V. Phone/Fax

Practice location:
  • Phone: 501-922-2217
  • Fax: 501-922-4216
Mailing address:
  • Phone: 501-520-5476
  • Fax: 501-520-5486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberA004393
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: