Basic Information
| Provider Information | |||||||||
| NPI: | 1225464126 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARKEY | ||||||||
| FirstName: | LEE-MARIE | ||||||||
| MiddleName: | DAVIS | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 131 WELTON WAY | ||||||||
| Address2: | |||||||||
| City: | MOORESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281179163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043604564 | ||||||||
| FaxNumber: | 7043161636 | ||||||||
| Practice Location | |||||||||
| Address1: | 131 WELTON WAY | ||||||||
| Address2: | |||||||||
| City: | MOORESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281179163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043604564 | ||||||||
| FaxNumber: | 7043604553 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2013 | ||||||||
| LastUpdateDate: | 04/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 5006489 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.