Healthcare Provider Details

I. General information

NPI: 1245412337
Provider Name (Legal Business Name): NANCY ANN HARDIES RN, NP, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2007
Last Update Date: 11/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 LAGUNA HONDA BLVD
SAN FRANCISCO CA
94116-1411
US

IV. Provider business mailing address

2712 MISSION ST LOWER LEVEL
SAN FRANCISCO CA
94110-3104
US

V. Phone/Fax

Practice location:
  • Phone: 415-573-3690
  • Fax:
Mailing address:
  • Phone: 415-401-2667
  • Fax: 415-401-2664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number280608
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number7961
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number1098
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: