Provider Demographics
NPI:1174773824
Name:HARDY, ANGELA LASHAY (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:LASHAY
Last Name:HARDY
Suffix:
Gender:F
Credentials:DNP, 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:PO BOX 258
Mailing Address - Street 2:
Mailing Address - City:GIBSLAND
Mailing Address - State:LA
Mailing Address - Zip Code:71028-0258
Mailing Address - Country:US
Mailing Address - Phone:318-458-8880
Mailing Address - Fax:
Practice Address - Street 1:775 FIRST ST
Practice Address - Street 2:
Practice Address - City:GIBSLAND
Practice Address - State:LA
Practice Address - Zip Code:71028
Practice Address - Country:US
Practice Address - Phone:318-458-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05586363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LARN107298OtherRN LICENSE INFORMATION