Provider Demographics
NPI:1942078068
Name:HARDT, STEPHANIE MARIE (NP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MARIE
Last Name:HARDT
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:660 MASON RIDGE CENTER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8512
Mailing Address - Country:US
Mailing Address - Phone:314-448-3791
Mailing Address - Fax:314-996-7658
Practice Address - Street 1:4 MEMORIAL DR STE 130
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-6704
Practice Address - Country:US
Practice Address - Phone:618-463-7601
Practice Address - Fax:618-463-7601
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2024-04-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2021029978363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner