Provider Demographics
NPI:1700954658
Name:HARVEY, DONNA K (CRNA)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:K
Last Name:HARVEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 W HOLCOMBE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-790-9412
Mailing Address - Fax:713-790-9738
Practice Address - Street 1:2727 W HOLCOMBE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025
Practice Address - Country:US
Practice Address - Phone:713-790-9412
Practice Address - Fax:713-790-9738
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX249413367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80765CMedicare ID - Type Unspecified