Healthcare Provider Details

I. General information

NPI: 1922722768
Provider Name (Legal Business Name): EMMA LEIGH HARVIE MS, CNS, LN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2022
Last Update Date: 09/26/2022
Certification Date: 09/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 UNITED AVE SE UNIT 301
ATLANTA GA
30312-3684
US

IV. Provider business mailing address

840 UNITED AVE SE UNIT 301
ATLANTA GA
30312-3684
US

V. Phone/Fax

Practice location:
  • Phone: 218-343-1633
  • Fax:
Mailing address:
  • Phone: 218-343-1633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberN243
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: