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General NPI Number Information
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NPI Number | 1932675758
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Entity Type | Individual
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Provider Name | JASON LAMARR HARDIN MSN, APRN, AGNP-C
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Gender | Male
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Dates
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Enumeration Date | 10/18/2018
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Last Update Date | 03/11/2020
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Provider Practice Location Address
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Address Line | 6010 E W T HARRIS BLVD
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City | CHARLOTTE
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State | NC
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Zip | 28215-4084
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Country | US
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Telephone | 704-208-4134
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Fax | 704-248-8068
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Provider Business Mailing Address
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Address Line | 6010 E W T HARRIS BLVD
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City | CHARLOTTE
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State | NC
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Zip | 28215-4084
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Country | US
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Telephone | 704-208-4134
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Fax | 704-248-8068
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 5011129
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License Number State | NC
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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 | 5011129
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License Number State | NC
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