Provider Demographics
NPI:1053020974
Name:HARVEY, ANISA (DNP, RN)
Entity type:Individual
Prefix:
First Name:ANISA
Middle Name:
Last Name:HARVEY
Suffix:
Gender:F
Credentials:DNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 E BETTERAVIA RD STE D303
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-8808
Mailing Address - Country:US
Mailing Address - Phone:352-216-9004
Mailing Address - Fax:
Practice Address - Street 1:540 E BETTERAVIA RD STE D303
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-8808
Practice Address - Country:US
Practice Address - Phone:352-216-9004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9263520163WP0809X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult