Healthcare Provider Details

I. General information

NPI: 1699498527
Provider Name (Legal Business Name): LORI ANN HARVIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2022
Last Update Date: 03/27/2023
Certification Date: 03/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 WEST NORTH AVENUE SUITE 131 M
BALTIMORE MD
21216
US

IV. Provider business mailing address

1603 WOODLING WAY
PIKESVILLE MD
21208-2835
US

V. Phone/Fax

Practice location:
  • Phone: 410-951-4188
  • Fax: 410-951-6158
Mailing address:
  • Phone: 443-829-8395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR140288
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: