Provider Demographics
NPI:1295805455
Name:HARDIN, MARY FRANCES (ARNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:FRANCES
Last Name:HARDIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 MORGAN FOUR OAKS RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:KY
Mailing Address - Zip Code:41040-8197
Mailing Address - Country:US
Mailing Address - Phone:859-654-4571
Mailing Address - Fax:
Practice Address - Street 1:341 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-2116
Practice Address - Country:US
Practice Address - Phone:859-879-1915
Practice Address - Fax:859-987-3230
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1730P363LW0102X
KY3001730363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100184530Medicaid