| Doctor Name: | CHARLIE M HARDIN |
| NPI Number: | 1669450037 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CFNP/ACNP |
| License Number: | R857156 |
| Business Practice Address: | 110 Park Street Walnut Grove, MS - 39189 |
| Business Phone Number: | 6012530173 |
| Business Fax Number: | 6012530176 |
| Mailing Address: | P.o. Box 160, WALNUT GROVE |
| State: | MS |
| Postal Code: | 39189 |
| Phone Number: | 3012530173 |
| Fax Number: | 6012530176 |
| NPI Enumeration Date: | 01/05/2006 |
| NPI Last Update Date: | 03/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | R857156 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |