Provider Demographics
NPI:1023089018
Name:ILARDI, MARIA M (ARNP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:M
Last Name:ILARDI
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Gender:F
Credentials:ARNP
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Mailing Address - Street 1:1311 WAKARUSA DR
Mailing Address - Street 2:STE 2117
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-4775
Mailing Address - Country:US
Mailing Address - Phone:785-843-9192
Mailing Address - Fax:785-843-6744
Practice Address - Street 1:200 MAINE ST
Practice Address - Street 2:STE A
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1368
Practice Address - Country:US
Practice Address - Phone:785-843-9192
Practice Address - Fax:785-843-6744
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2019-09-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS74626364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100097940AMedicaid
P16966Medicare UPIN