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NPI 1669567137

NPI 1669567137 : JENNIFER LYNN HARDIN P.A.-C. : MOREHEAD, KY

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General NPI Number Information
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    NPI Number           |    1669567137
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    Entity Type          |    Individual 
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    Provider Name        |    JENNIFER LYNN HARDIN P.A.-C.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/03/2006
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    Last Update Date     |    05/02/2018
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Provider Practice Location Address
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    Address Line         |    245 FLEMINGSBURG RD 
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    City                 |    MOREHEAD
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    State                |    KY
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    Zip                  |    40351-1015
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    Country              |    US
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    Telephone            |    606-780-5500
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    Fax                  |    606-783-7281
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Provider Business Mailing Address
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    Address Line         |    405 CLINIC DR 
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    City                 |    MOREHEAD
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    State                |    KY
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    Zip                  |    40351-1077
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    Country              |    US
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    Telephone            |    606-780-5500
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    Fax                  |    606-783-7281
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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        |    363AM0700X
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    Taxonomy Name        |    Medical Physician Assistant
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    License Number       |    PA412
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    License Number State |    KY
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Taxonomy #2
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    PA412
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    License Number State |    KY
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