Healthcare Provider Details

I. General information

NPI: 1275954109
Provider Name (Legal Business Name): AMANDA HARDESTY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA PFIRRMAN NP

II. Dates (important events)

Enumeration Date: 12/19/2013
Last Update Date: 02/10/2020
Certification Date: 02/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 BURNET AVE
CINCINNATI OH
45229-3014
US

IV. Provider business mailing address

3101 BURNET AVE
CINCINNATI OH
45229-3014
US

V. Phone/Fax

Practice location:
  • Phone: 513-357-2808
  • Fax: 513-357-2811
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.026059
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number393818
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: