MEDICARE: MRS. KOSETTE HARDY REGISTERED NURSE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	449282	OH

General Provider Information

NPI Number	:	1154600682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KOSETTE HARDY REGISTERED NURSE

Provider Business Mailing Address
First Line	:	1852 NASON AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-1678
Country	:	US
Telephone Number	:	614-390-6379
Fax Number	:

Provider Business Practice Location Address
First Line	:	1852 NASON AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-1678
Country	:	US
Telephone Number	:	614-390-6379
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2011
Last Update Date	:	07/19/2021

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