Provider Demographics
NPI:1194338301
Name:HARDY, NIKITA LAUREN (MPA)
Entity type:Individual
Prefix:
First Name:NIKITA
Middle Name:LAUREN
Last Name:HARDY
Suffix:
Gender:F
Credentials:MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 SPRING RD
Mailing Address - Street 2:
Mailing Address - City:GLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12302-2725
Mailing Address - Country:US
Mailing Address - Phone:518-707-6850
Mailing Address - Fax:
Practice Address - Street 1:131 SPRING RD
Practice Address - Street 2:
Practice Address - City:GLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12302-2725
Practice Address - Country:US
Practice Address - Phone:518-707-6850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula