Healthcare Provider Details

I. General information

NPI: 1659749471
Provider Name (Legal Business Name): KRISTINA C HARDY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2015
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7440 S 91ST ST
LINCOLN NE
68526-9797
US

IV. Provider business mailing address

390 9TH ST
FLORENCE OR
97439-9470
US

V. Phone/Fax

Practice location:
  • Phone: 402-327-2700
  • Fax: 402-328-3716
Mailing address:
  • Phone: 541-997-7134
  • Fax: 888-965-0959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10011957
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number111817
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: