MEDICARE: KATELYNN ANN HARDESTY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	372600000X	Adult Companion
2	3747P1801X	Personal Care Attendant
3	372500000X	Chore Provider

General Provider Information

NPI Number	:	1720947419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYNN ANN HARDESTY

Provider Business Mailing Address
First Line	:	18217 CARY ST APT 229
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68136-1759
Country	:	US
Telephone Number	:	531-289-8340
Fax Number	:

Provider Business Practice Location Address
First Line	:	18217 CARY ST APT 229
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68136-1759
Country	:	US
Telephone Number	:	531-289-8340
Fax Number	:

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

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “ KATELYNN ANN HARDESTY ” Practice Location

Language	Start Address	Practice Location

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