Provider Demographics
NPI:1912956061
Name:HARDY, PAULA (FNP-C)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:HARDY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 TAPESTRY RDG
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-6647
Mailing Address - Country:US
Mailing Address - Phone:678-378-0343
Mailing Address - Fax:678-378-0343
Practice Address - Street 1:1645 TAPESTRY RDG
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-6647
Practice Address - Country:US
Practice Address - Phone:678-378-0343
Practice Address - Fax:678-378-0343
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2013-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN118684363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily