Healthcare Provider Details

I. General information

NPI: 1285549295
Provider Name (Legal Business Name): ERICA HARDIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E FOREST AVE
JACKSON TN
38301-4190
US

IV. Provider business mailing address

110 E FOREST AVE
JACKSON TN
38301-4190
US

V. Phone/Fax

Practice location:
  • Phone: 731-300-7155
  • Fax:
Mailing address:
  • Phone: 731-300-7155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number41947
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: