Healthcare Provider Details

I. General information

NPI: 1831375039
Provider Name (Legal Business Name): DENNIFER D HARDY A.R.N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. DENNIFER D MAYO

II. Dates (important events)

Enumeration Date: 01/17/2008
Last Update Date: 11/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

193 FRONT ST SUITE 5
FARMINGTON ME
04938-5834
US

IV. Provider business mailing address

PO BOX 587
AUGUSTA ME
04332-0587
US

V. Phone/Fax

Practice location:
  • Phone: 207-778-4553
  • Fax: 207-778-2041
Mailing address:
  • Phone: 207-509-3271
  • Fax: 207-660-4203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberARNP 3019442
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: