Provider Demographics
NPI:1437112786
Name:HARDY, JESSICA (L AC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:HARDY
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4720 BEACH CT
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-1154
Mailing Address - Country:US
Mailing Address - Phone:720-939-0754
Mailing Address - Fax:
Practice Address - Street 1:4110 TENNYSON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-2117
Practice Address - Country:US
Practice Address - Phone:720-939-0754
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO 971171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist