Provider Demographics
NPI:1629619143
Name:HARDINGER, MONTE M
Entity Type:Individual
Prefix:
First Name:MONTE
Middle Name:M
Last Name:HARDINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 N 250 W
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-1932
Mailing Address - Country:US
Mailing Address - Phone:801-739-3236
Mailing Address - Fax:
Practice Address - Street 1:298 N 250 W
Practice Address - Street 2:
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-1932
Practice Address - Country:US
Practice Address - Phone:801-739-3236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-06
Last Update Date:2019-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5919083-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse