Provider Demographics
NPI:1073265013
Name:HARDY, MARCELLA NICOLE (MSN APRN FNP-C)
Entity Type:Individual
Prefix:
First Name:MARCELLA
Middle Name:NICOLE
Last Name:HARDY
Suffix:
Gender:F
Credentials:MSN APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 WAVA DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT WASHINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40047-7778
Mailing Address - Country:US
Mailing Address - Phone:502-794-7104
Mailing Address - Fax:
Practice Address - Street 1:593 WAVA DR
Practice Address - Street 2:
Practice Address - City:MOUNT WASHINGTON
Practice Address - State:KY
Practice Address - Zip Code:40047-7778
Practice Address - Country:US
Practice Address - Phone:150-279-4710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017203363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care