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Individual

LISA ELLEN HARVEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
424 YELLOWSTONE AVE, STE 120, CODY, WY 82414
(307) 578-7207
(307) 578-1256
Mailing address
707 SHERIDAN AVE, CODY, WY 82414
(307) 578-2480
(307) 578-2492

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
200400810
NC
207Q00000X
Family Medicine Physician
Primary
TL1383
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200400810
STATE LICENSE
NC
Enumeration date
02/16/2006
Last updated
02/23/2022
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