MEDICARE: JONISIA D 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
1	374U00000X	Home Health Aide	2106406539	NV

General Provider Information

NPI Number	:	1487305744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONISIA D HARVEY

Provider Business Mailing Address
First Line	:	4730 E CRAIG RD UNIT 1124
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-2595
Country	:	US
Telephone Number	:	661-941-7432
Fax Number	:

Provider Business Practice Location Address
First Line	:	4730 E CRAIG RD UNIT 1124
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-2595
Country	:	US
Telephone Number	:	661-941-7432
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2022
Last Update Date	:	01/18/2022

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Directions to “ JONISIA D HARVEY ” Practice Location

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