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General NPI Number Information
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NPI Number | 1881009934
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Entity Type | Individual
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Provider Name | LAUREN NICOLE HARDY PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/27/2014
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 102 HOSPITALITY DR
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City | SIKESTON
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State | MO
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Zip | 63801-9382
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Country | US
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Telephone | 573-471-0200
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Fax | 573-475-7631
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Provider Business Mailing Address
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Address Line | 1008 N MAIN ST
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City | SIKESTON
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State | MO
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Zip | 63801-5044
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Country | US
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Telephone | 573-471-0200
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Fax | 573-471-7559
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2014020545
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License Number State | MO
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