Healthcare Provider Details

I. General information

NPI: 1811346539
Provider Name (Legal Business Name): TIA HARDESTY APN-NP PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22422 E MAIN ST
PARKER CO
80138-7267
US

IV. Provider business mailing address

2480 S JEBEL WAY
AURORA CO
80013-8999
US

V. Phone/Fax

Practice location:
  • Phone: 303-841-7857
  • Fax: 303-209-7854
Mailing address:
  • Phone: 720-296-9744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License NumberRN.0202553
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.0993419-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: