Healthcare Provider Details

I. General information

NPI: 1083381420
Provider Name (Legal Business Name): JENNIFER HARVEY FNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 PLEASANTVILLE LN
WEST END NC
27376-8798
US

IV. Provider business mailing address

PO BOX 1056
SOUTHERN PINES NC
28388-1056
US

V. Phone/Fax

Practice location:
  • Phone: 843-206-4300
  • Fax:
Mailing address:
  • Phone: 910-303-3624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2023165799
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5015138
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: