Provider Demographics
NPI:1932675758
Name:HARDIN, JASON LAMARR (MSN, APRN, AGNP-C)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:LAMARR
Last Name:HARDIN
Suffix:
Gender:M
Credentials:MSN, APRN, AGNP-C
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Mailing Address - Street 1:6010 E W T HARRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-4084
Mailing Address - Country:US
Mailing Address - Phone:704-208-4134
Mailing Address - Fax:704-248-8068
Practice Address - Street 1:6010 E W T HARRIS BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-4084
Practice Address - Country:US
Practice Address - Phone:704-208-4134
Practice Address - Fax:704-248-8068
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5011129207RI0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease