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General NPI Number Information
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NPI Number | 1003122201
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Entity Type | Individual
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Provider Name | JACOB WILLIAM HARVEY JR. APRN-FNP
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Gender | Male
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Dates
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Enumeration Date | 08/25/2010
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 516 W BRECKINRIDGE ST
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City | LOUISVILLE
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State | KY
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Zip | 40203-2128
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Country | US
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Telephone | 502-648-7909
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Fax |
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Provider Business Mailing Address
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Address Line | 516 W BRECKINRIDGE ST
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City | LOUISVILLE
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State | KY
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Zip | 40203-2128
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Country | US
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Telephone | 502-377-1406
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3006597
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 6597
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License Number State | KY
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