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General NPI Number Information
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NPI Number | 1609330216
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Entity Type | Individual
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Provider Name | ERIKA LYN HARDEEN
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Gender | Female
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Dates
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Enumeration Date | 01/28/2019
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Last Update Date | 01/28/2019
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Provider Practice Location Address
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Address Line | 113 WOOD RD
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City | BALLSTON SPA
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State | NY
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Zip | 12020-2217
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Country | US
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Telephone | 518-321-6018
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Fax |
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Provider Business Mailing Address
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Address Line | 26 KNICKERBOCKER ST
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City | BALLSTON SPA
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State | NY
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Zip | 12020-1125
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Country | US
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Telephone | 518-859-8428
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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 | 258182-1
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License Number State | NY
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