Individual provider · NPI-1

Lisa Ellen Harvey, MD

Family Medicine · Cody, WY

NPI number1477527299
StatusActive
Last updated in NPPESFeb 23, 2022

Details

NPI
1477527299
Entity type
Individual (NPI-1)
Name
Lisa Ellen Harvey
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
Feb 16, 2006
Certification date
Feb 23, 2022
Last updated
Feb 23, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineTL1383WYYes
207Q00000X Family Medicine200400810NC

Practice location

424 Yellowstone Ave
Ste 120
Cody, WY 82414

Phone 307-578-7207 · Fax 307-578-1256

Mailing address

707 Sheridan Ave
Cody, WY 82414

Phone 307-578-2480 · Fax 307-578-2492

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