Healthcare Provider Details

I. General information

NPI: 1144580523
Provider Name (Legal Business Name): TONIEKA HARDY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2012
Last Update Date: 05/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 SARATOGA AVE NE APT 3
WASHINGTON DC
20018-1965
US

IV. Provider business mailing address

1308 SARATOGA AVE NE APT 3
WASHINGTON DC
20018-1965
US

V. Phone/Fax

Practice location:
  • Phone: 202-200-3233
  • Fax:
Mailing address:
  • Phone: 202-200-3233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number2451653
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: