Healthcare Provider Details

I. General information

NPI: 1134335540
Provider Name (Legal Business Name): DEBORAH LOUISE HARDMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 BELMONT ST
BROCKTON MA
02301-5596
US

IV. Provider business mailing address

16 NADINE RD
BROCKTON MA
02302-4144
US

V. Phone/Fax

Practice location:
  • Phone: 774-826-1426
  • Fax: 774-826-1840
Mailing address:
  • Phone: 508-584-9198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number164385
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: