MEDICARE: ERICA HARDEN A.R.N.P.

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	363L00000X	Nurse Practitioner	ARNP9203636	FL

General Provider Information

NPI Number	:	1295014777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA HARDEN A.R.N.P.

Provider Business Mailing Address
First Line	:	1149 MAIN ST
Second Line	:
City	:	LADY LAKE
State	:	FL
Zip	:	32159-7721
Country	:	US
Telephone Number	:	352-647-2080
Fax Number	:

Provider Business Practice Location Address
First Line	:	1149 MAIN ST
Second Line	:
City	:	LADY LAKE
State	:	FL
Zip	:	32159-7721
Country	:	US
Telephone Number	:	352-647-2080
Fax Number	:	352-647-2177

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

Provider Enumeration Date	:	08/15/2011
Last Update Date	:	02/10/2014

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