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NPI Code Detail

MEDICARE: CARLISSA HARVEY

MEDICARE: CARLISSA HARVEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency
2374U00000XHome Health Aide
3251E00000XHome Health AgencyLC9814754MO

General Provider Information

NPI Number : 1043763154
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLISSA HARVEY
Provider Business Mailing Address
First Line : 3310 MERAMEC ST
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63118-4311
Country : US
Telephone Number : 314-749-0152
Fax Number : 844-316-0208
Provider Business Practice Location Address
First Line : 3310 MERAMEC ST
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63118-4311
Country : US
Telephone Number : 314-749-0152
Fax Number : 844-316-0208
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2016
Last Update Date : 06/08/2023

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Directions to “ CARLISSA HARVEY ” Practice Location

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