MEDICARE: MRS. MARTHA L HARDESTY RN

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	163W00000X	Registered Nurse	RN085071	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821146234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARTHA L HARDESTY RN

Provider Business Mailing Address
First Line	:	418 PARK AVE
Second Line	:
City	:	ZANESVILLE
State	:	OH
Zip	:	43701
Country	:	US
Telephone Number	:	740-454-7444
Fax Number	:

Provider Business Practice Location Address
First Line	:	43 WEST 7TH ST
Second Line	:
City	:	DRESDEN
State	:	OH
Zip	:	43821
Country	:	US
Telephone Number	:	740-754-4891
Fax Number	:

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

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/08/2007

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