Provider Demographics
NPI:1073948816
Name:HARDMON, LAPORSCHA MICHELLE (NP)
Entity Type:Individual
Prefix:
First Name:LAPORSCHA
Middle Name:MICHELLE
Last Name:HARDMON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:492C CEDAR LN STE 514
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-1713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2120 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:DIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02715-1502
Practice Address - Country:US
Practice Address - Phone:617-823-4476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5018469363LF0000X
MARN2277479163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse