Provider Demographics
NPI:1841368552
Name:HARDY, KIMBERLY BROADY (DNP,MSN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:BROADY
Last Name:HARDY
Suffix:
Gender:F
Credentials:DNP,MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2459 EMERALD PL STE 102
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-5739
Mailing Address - Country:US
Mailing Address - Phone:252-757-3939
Mailing Address - Fax:252-757-3973
Practice Address - Street 1:2459 EMERALD PL STE 102
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5739
Practice Address - Country:US
Practice Address - Phone:252-757-3939
Practice Address - Fax:252-757-3973
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201605363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily