Healthcare Provider Details

I. General information

NPI: 1598482721
Provider Name (Legal Business Name): IVANNA HARSHMAN CPNP-PC, PMHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. IVANNA BUCHYNSKY

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6655 SANTA BARBARA RD
ELKRIDGE MD
21075-7500
US

IV. Provider business mailing address

6655 SANTA BARBARA RD
ELKRIDGE MD
21075-7500
US

V. Phone/Fax

Practice location:
  • Phone: 866-968-6342
  • Fax:
Mailing address:
  • Phone: 866-968-6342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR233624
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License Number20259383
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: