Provider Demographics
NPI:1063730331
Name:NARDIN-HARDY, REBECCA (RDN,LD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:NARDIN-HARDY
Suffix:
Gender:F
Credentials:RDN,LD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:HARDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN,LD
Mailing Address - Street 1:L-3549
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43260-0001
Mailing Address - Country:US
Mailing Address - Phone:740-383-7927
Mailing Address - Fax:740-383-7942
Practice Address - Street 1:#6 LEXINGTON BLVD
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1047
Practice Address - Country:US
Practice Address - Phone:740-363-7181
Practice Address - Fax:740-363-7962
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.4105133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH128940Medicare PIN