Provider Demographics
NPI:1548240187
Name:HARDY, NORA R (CNM)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:R
Last Name:HARDY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2535 MINER LAKE DR
Mailing Address - Street 2:
Mailing Address - City:ALLEGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49010-9525
Mailing Address - Country:US
Mailing Address - Phone:269-341-7979
Mailing Address - Fax:269-341-6261
Practice Address - Street 1:2535 MINER LAKE DR
Practice Address - Street 2:
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-9525
Practice Address - Country:US
Practice Address - Phone:269-399-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704209187367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3496366Medicaid
MI3496366Medicaid
MIM74680001Medicare PIN