MEDICARE: EMILY ELAINE HARDIN

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	376J00000X	Homemaker

General Provider Information

NPI Number	:	1639918345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY ELAINE HARDIN

Provider Business Mailing Address
First Line	:	2401 RAVENEL DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43209-3308
Country	:	US
Telephone Number	:	317-417-4651
Fax Number	:

Provider Business Practice Location Address
First Line	:	10455 EMELIA PL
Second Line	:
City	:	PLAIN CITY
State	:	OH
Zip	:	43064-7515
Country	:	US
Telephone Number	:	740-360-2744
Fax Number	:

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

Provider Enumeration Date	:	05/22/2024
Last Update Date	:	05/22/2024

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