Provider Demographics
NPI:1457027500
Name:HARDEN, RENITA J (APNP)
Entity Type:Individual
Prefix:
First Name:RENITA
Middle Name:J
Last Name:HARDEN
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:RENITA
Other - Middle Name:J
Other - Last Name:BECKIUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3029 MAPLE VALLEY DR APT 101
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-3185
Mailing Address - Country:US
Mailing Address - Phone:763-257-5679
Mailing Address - Fax:
Practice Address - Street 1:7818 BIG SKY DR STE 101
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-2840
Practice Address - Country:US
Practice Address - Phone:608-713-9898
Practice Address - Fax:608-203-6696
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6199-33363LA2100X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care