Provider Demographics
NPI:1346957222
Name:HARDWICK, SHANE A (PARAMEDIC)
Entity Type:Individual
Prefix:MR
First Name:SHANE
Middle Name:A
Last Name:HARDWICK
Suffix:
Gender:M
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6731 CHAPEL XING
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-7844
Mailing Address - Country:US
Mailing Address - Phone:317-213-3700
Mailing Address - Fax:
Practice Address - Street 1:6731 CHAPEL XING
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-7844
Practice Address - Country:US
Practice Address - Phone:317-213-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic