Provider Demographics
NPI:1235436064
Name:HARDWAY, MELODY (RN-ANP)
Entity Type:Individual
Prefix:MS
First Name:MELODY
Middle Name:
Last Name:HARDWAY
Suffix:
Gender:F
Credentials:RN-ANP
Other - Prefix:MS
Other - First Name:MELODY
Other - Middle Name:JOYCE
Other - Last Name:HARDWAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:7202 MARSH TER
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-3231
Mailing Address - Country:US
Mailing Address - Phone:772-618-3987
Mailing Address - Fax:
Practice Address - Street 1:18167 US HIGHWAY 19 N
Practice Address - Street 2:SUITE 650
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-3528
Practice Address - Country:US
Practice Address - Phone:727-437-0821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28147300A163WC0200X, 163WM0705X, 363LA2200X
FLARNP9366389363LA2200X
TXAP138789363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health