Provider Demographics
NPI:1881392975
Name:HARVEY, ALICE
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:HARVEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 INDEPENDENCE CT
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21617-2203
Mailing Address - Country:US
Mailing Address - Phone:302-312-7517
Mailing Address - Fax:
Practice Address - Street 1:138 CATHEDRAL ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5568
Practice Address - Country:US
Practice Address - Phone:443-372-8226
Practice Address - Fax:443-372-8232
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR212772163W00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse