MEDICARE: KATHRINE HARDY FNP

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
1	363LF0000X	Family Nurse Practitioner	1278	AK

General Provider Information

NPI Number	:	1225032915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRINE HARDY FNP

Provider Business Mailing Address
First Line	:	1201 N MULDOON RD # 2C-122
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99504-6104
Country	:	US
Telephone Number	:	72-575-4369
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 N MULDOON RD # 2C-122
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99504-6104
Country	:	US
Telephone Number	:	907-257-5436
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	05/06/2022

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