Healthcare Provider Details

I. General information

NPI: 1063636116
Provider Name (Legal Business Name): JULIANNE A HARDNETT FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 N MAIN ST
DECATUR IL
62523-1206
US

IV. Provider business mailing address

4834 S BAKER WOODS CT
DECATUR IL
62521-4276
US

V. Phone/Fax

Practice location:
  • Phone: 217-362-6262
  • Fax:
Mailing address:
  • Phone: 616-745-8119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704335816
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: