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NPI Code Detail

MEDICARE: KELLIE L HARDY NURSE PRACTITIONER

MEDICARE: KELLIE L HARDY NURSE PRACTITIONER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner53-79804-051KS
2363L00000XNurse Practitioner2020039162MO
3363LF0000XFamily Nurse Practitioner2020039162MO
4363LF0000XFamily Nurse Practitioner5379804051KS

General Provider Information

NPI Number : 1154927606
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLIE L HARDY NURSE PRACTITIONER
Provider Business Mailing Address
First Line : PO BOX 746874
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6874
Country : US
Telephone Number : 913-951-8731
Fax Number :
Provider Business Practice Location Address
First Line : 700 NEBRASKA AVE
Second Line :
City : KANSAS CITY
State : KS
Zip : 66101-2111
Country : US
Telephone Number : 913-951-8731
Fax Number : 913-426-9057
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2020
Last Update Date : 05/07/2024

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Directions to “ KELLIE L HARDY NURSE PRACTITIONER” Practice Location

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