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General NPI Number Information
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NPI Number | 1598176273
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Entity Type | Individual
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Provider Name | SHALENTA HARDISON APRN
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Gender | Female
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Dates
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Enumeration Date | 05/15/2014
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Last Update Date | 04/15/2024
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Provider Practice Location Address
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Address Line | 245 ORANGE AVE
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City | MILFORD
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State | CT
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Zip | 06461-2104
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Country | US
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Telephone | 203-876-5123
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Fax |
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Provider Business Mailing Address
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Address Line | 46 SHERWOOD RD
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City | EASTON
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State | CT
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Zip | 06612-1210
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Country | US
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Telephone | 929-219-8944
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 316587
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 10052
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10052
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License Number State | CT
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