Healthcare Provider Details

I. General information

NPI: 1730339482
Provider Name (Legal Business Name): KIMBERLY LOUISE HARVEY P.A.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13450 N MERIDIAN ST STE 145
CARMEL IN
46032
US

IV. Provider business mailing address

13450 N MERIDIAN ST STE 145
CARMEL IN
46032-1484
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-8788
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number10001047A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10001047A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: