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NPI Code Detail

MEDICARE: SHALENTA HARDISON APRN

MEDICARE: SHALENTA HARDISON APRN
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
1164W00000XLicensed Practical Nurse316587NY
2367500000XCertified Registered Nurse Anesthetist10052CT
3363LF0000XFamily Nurse Practitioner10052CT
4367500000XCertified Registered Nurse Anesthetist117345-23NH
5363LP0808XPsychiatric/Mental Health Nurse Practitioner10052CT

General Provider Information

NPI Number : 1598176273
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHALENTA HARDISON APRN
Provider Business Mailing Address
First Line : 46 SHERWOOD RD
Second Line :
City : EASTON
State : CT
Zip : 06612-1210
Country : US
Telephone Number : 929-219-8944
Fax Number :
Provider Business Practice Location Address
First Line : 245 ORANGE AVE
Second Line :
City : MILFORD
State : CT
Zip : 06461-2104
Country : US
Telephone Number : 203-876-5123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2014
Last Update Date : 05/07/2026

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