Doctor Name: | MELISSA KARN HARDISON |
NPI Number: | 1386078624 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | RN169970 |
Business Practice Address: | 1111 Griffin Ave Eastman, GA - 310239104 |
Business Phone Number: | 4783748998 |
Business Fax Number: | |
Mailing Address: | 1111 Griffin Ave, EASTMAN |
State: | GA |
Postal Code: | 310239104 |
Phone Number: | 4783748998 |
Fax Number: | |
NPI Enumeration Date: | 08/22/2013 |
NPI Last Update Date: | 08/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN169970 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |