Provider Demographics
NPI:1770191470
Name:HARDY, ROBERT ADAM (DNP)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ADAM
Last Name:HARDY
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:ADAM
Other - Middle Name:
Other - Last Name:HARDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DNP
Mailing Address - Street 1:2000 HEALTH PARK DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4525
Mailing Address - Country:US
Mailing Address - Phone:615-372-5068
Mailing Address - Fax:
Practice Address - Street 1:3651 WHEELER RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6426
Practice Address - Country:US
Practice Address - Phone:706-651-2420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-19
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN258309363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily