Hardy, Wauntesha
Hardy, Wauntesha is an individual health care provider with primary practice located at 3920 St Francis Way Ste 209 , Lafayette IN 47905-4917. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Hardy, Wauntesha can be contacted via phone (765) 775-2830.Contact Information
Primary practice address
3920 St Francis Way Ste 209
Lafayette IN 47905-4917
Phone: (765) 775-2830
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | 28193111A | Indiana |
Profile Details
| NPI number | 1518487677 |
|---|---|
| LBN Legal business name | Hardy, Wauntesha |
| Credentials | AGPCNP-BC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 20th, 2017 |
| Last updated | Mar 13th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518487677 | NPPES |
| Indiana | Other | 471400463 | MEDICARE |
| Indiana | MEDICAID | 300004440 | MEDICARE |
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