Doctor Name: | DIANA C HARDWICK |
NPI Number: | 1154538916 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | R 0035732 |
Business Practice Address: | 200 Mcdougal Dr Holdenville, OK - 748482811 |
Business Phone Number: | 4053793313 |
Business Fax Number: | |
Mailing Address: | 7737 E 135 Rd, HOLDENVILLE |
State: | OK |
Postal Code: | 748486205 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/17/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LW0102X |
License Number: | R 0035732 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Women's Health |
Taxonomy Definition: |