Provider Demographics
NPI:1366027922
Name:HARDER, DUSTIN SCOTT (APRN)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:SCOTT
Last Name:HARDER
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7454 EBERHART RD NW
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:OH
Mailing Address - Zip Code:44612-8925
Mailing Address - Country:US
Mailing Address - Phone:330-432-2968
Mailing Address - Fax:
Practice Address - Street 1:155 GARLAND DR SW
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-6300
Practice Address - Country:US
Practice Address - Phone:330-556-6518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028548363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner