Healthcare Provider Details

I. General information

NPI: 1417470824
Provider Name (Legal Business Name): BRIAN D HARDMAN FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2017
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 EMERSON AVE
PARKERSBURG WV
26104-2526
US

IV. Provider business mailing address

911 EMERSON AVE
PARKERSBURG WV
26104-2526
US

V. Phone/Fax

Practice location:
  • Phone: 304-865-5444
  • Fax: 304-865-5445
Mailing address:
  • Phone: 304-865-5444
  • Fax: 304-865-5445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number75939
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number75939
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: