Provider Demographics
NPI:1487937488
Name:HARVEY, ABBEY RENEE (ACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ABBEY
Middle Name:RENEE
Last Name:HARVEY
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:MISS
Other - First Name:ABBEY
Other - Middle Name:RENEE
Other - Last Name:FRISTIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACNP-BC
Mailing Address - Street 1:1001 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44504-1003
Mailing Address - Country:US
Mailing Address - Phone:330-747-1106
Mailing Address - Fax:330-747-0491
Practice Address - Street 1:1001 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1003
Practice Address - Country:US
Practice Address - Phone:330-747-1106
Practice Address - Fax:330-747-0491
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.12596363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0059347Medicaid