Provider Demographics
NPI:1801824628
Name:HARDY, VANESSA K (APN)
Entity Type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:K
Last Name:HARDY
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 501123
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-0001
Mailing Address - Country:US
Mailing Address - Phone:615-284-8740
Mailing Address - Fax:615-284-8644
Practice Address - Street 1:4601 CAROTHERS PARKWAY
Practice Address - Street 2:STE. 350
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:63150-0001
Practice Address - Country:US
Practice Address - Phone:615-284-4664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN10473363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
620476822OtherTAX ID
Q33639Medicare UPIN