Doctor Name: | MRS. SHELLIE D HARDCASTLE |
NPI Number: | 1033111901 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 3003194 |
Business Practice Address: | 250 Park St Bowling Green, KY - 421011760 |
Business Phone Number: | 2707451808 |
Business Fax Number: | 2707965516 |
Mailing Address: | 1870 Greenhill Rd, BOWLING GREEN |
State: | KY |
Postal Code: | 421039893 |
Phone Number: | 2707451808 |
Fax Number: | 2707965516 |
NPI Enumeration Date: | 08/11/2005 |
NPI Last Update Date: | 06/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 3003194 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |