Provider Demographics
NPI:1851443691
Name:HARDEN, PATRICIA D (NP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:D
Last Name:HARDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:119 AMBULANCE DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-3857
Mailing Address - Country:US
Mailing Address - Phone:256-449-2001
Mailing Address - Fax:256-449-2174
Practice Address - Street 1:76 COUNTY ROAD 64
Practice Address - Street 2:SUITE 3
Practice Address - City:WOODLAND
Practice Address - State:AL
Practice Address - Zip Code:36280-5209
Practice Address - Country:US
Practice Address - Phone:256-449-2001
Practice Address - Fax:256-449-2174
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2010-06-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL1-092465363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000883231AMedicaid
ALP18491Medicare UPIN
GA000883231AMedicaid