Provider Demographics
NPI:1831351196
Name:HARDIE, VIRGINIA C (MD)
Entity type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:C
Last Name:HARDIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1748 W. HORIZON RIDGE PKWY.
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-4833
Mailing Address - Country:US
Mailing Address - Phone:702-982-1300
Mailing Address - Fax:702-728-5661
Practice Address - Street 1:1748 W. HORIZON RIDGE PKWY.
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-4833
Practice Address - Country:US
Practice Address - Phone:702-982-1300
Practice Address - Fax:702-728-5661
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE25955207L00000X
NE5839208600000X
NV18489207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208600000XAllopathic & Osteopathic PhysiciansSurgery