Provider Demographics
NPI:1407387509
Name:HARDEE, ASHLEY LAUREN (NP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LAUREN
Last Name:HARDEE
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 1:86 MEDON MALESUS RD
Mailing Address - Street 2:
Mailing Address - City:MEDON
Mailing Address - State:TN
Mailing Address - Zip Code:38356-9193
Mailing Address - Country:US
Mailing Address - Phone:901-651-6764
Mailing Address - Fax:
Practice Address - Street 1:620 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3923
Practice Address - Country:US
Practice Address - Phone:901-651-6764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22384363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner