Provider Demographics
NPI:1831375039
Name:HARDY, DENNIFER D (ARNP)
Entity type:Individual
Prefix:MS
First Name:DENNIFER
Middle Name:D
Last Name:HARDY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:DENNIFER
Other - Middle Name:D
Other - Last Name:MAYO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 587
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04332-0587
Mailing Address - Country:US
Mailing Address - Phone:207-509-3271
Mailing Address - Fax:207-660-4203
Practice Address - Street 1:193 FRONT ST
Practice Address - Street 2:SUITE 5
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-5834
Practice Address - Country:US
Practice Address - Phone:207-778-4553
Practice Address - Fax:207-778-2041
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3019442363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E400195554Medicare PIN