Healthcare Provider Details

I. General information

NPI: 1346815016
Provider Name (Legal Business Name): RAEANN LYNETTE HARVEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2021
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 W PIERCE ST
CARLSBAD NM
88220-3553
US

IV. Provider business mailing address

PO BOX 680060
FRANKLIN TN
37068-0060
US

V. Phone/Fax

Practice location:
  • Phone: 575-887-4100
  • Fax:
Mailing address:
  • Phone: 877-848-1457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1129220
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number900842
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number88595
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: