Hardy, Wauntesha

Hardy, Wauntesha is an individual health care provider with primary practice located at 3920 St Francis Way Ste 209 , Lafayette IN 47905-4917. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Hardy, Wauntesha can be contacted via phone (765) 775-2830.

Contact Information

Primary practice address
3920 St Francis Way Ste 209 Lafayette IN 47905-4917
Phone: (765) 775-2830
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 28193111A Indiana

Profile Details

NPI number 1518487677
LBN Legal business name Hardy, Wauntesha
Credentials AGPCNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2017
Last updated Mar 13th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518487677 NPPES
Indiana Other 471400463 MEDICARE
Indiana MEDICAID 300004440 MEDICARE

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