Healthcare Provider Details

I. General information

NPI: 1053973198
Provider Name (Legal Business Name): SARAH ELIZABETH HARDWICK DNP, FNP-C, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2019
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 HARDING STREET
LODGE GRASS MT
59050-0780
US

IV. Provider business mailing address

PO BOX 633
RANCHESTER WY
82839-0633
US

V. Phone/Fax

Practice location:
  • Phone: 406-639-2317
  • Fax:
Mailing address:
  • Phone: 406-860-6175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number44093
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number44093
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: