Provider Demographics
NPI:1912283151
Name:HARDY-ESPINAL, ABIGAIL (PA)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:HARDY-ESPINAL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 ALCOVE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8574
Mailing Address - Country:US
Mailing Address - Phone:704-660-4750
Mailing Address - Fax:704-660-4751
Practice Address - Street 1:517 ALCOVE RD STE 102
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8574
Practice Address - Country:US
Practice Address - Phone:704-660-4750
Practice Address - Fax:704-660-4751
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-4954363A00000X
ALPA.785363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCL306AMedicare PIN