Provider Demographics
NPI:1689313736
Name:HARDMAN, ROBERTA SMITH (MSN APRN, AGACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ROBERTA
Middle Name:SMITH
Last Name:HARDMAN
Suffix:
Gender:F
Credentials:MSN APRN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 DENVER TRL
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76020-3614
Mailing Address - Country:US
Mailing Address - Phone:817-455-0640
Mailing Address - Fax:817-444-8783
Practice Address - Street 1:108 DENVER TRL
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-3614
Practice Address - Country:US
Practice Address - Phone:817-455-0640
Practice Address - Fax:817-444-8783
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-27
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX713462207RI0200X, 282NR1301X, 314000000X
TX1087032363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No282NR1301XHospitalsGeneral Acute Care HospitalRural
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility