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NPI Code Detail

MEDICARE: JIMMIE HARVEY MHPP

MEDICARE: JIMMIE HARVEY MHPP
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1538449400
Entity Type Code : Individual
Provider Name (Legal Business Name) : JIMMIE HARVEY MHPP
Provider Business Mailing Address
First Line : 1600 ALDERSGATE RD
Second Line : SUITE 200
City : LITTLE ROCK
State : AR
Zip : 72205-6614
Country : US
Telephone Number : 501-661-0720
Fax Number :
Provider Business Practice Location Address
First Line : 613 N FISHER ST
Second Line :
City : JONESBORO
State : AR
Zip : 72401-2152
Country : US
Telephone Number : 870-931-9547
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2011
Last Update Date : 08/24/2011

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Directions to “ JIMMIE HARVEY MHPP” Practice Location

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