Provider Demographics
NPI:1366157976
Name:HARDEN, MAURY (NP)
Entity type:Individual
Prefix:
First Name:MAURY
Middle Name:
Last Name:HARDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3715 DAUPHIN ST STE 3B
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1764
Mailing Address - Country:US
Mailing Address - Phone:251-206-9924
Mailing Address - Fax:
Practice Address - Street 1:3715 DAUPHIN ST STE 3B
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1764
Practice Address - Country:US
Practice Address - Phone:251-206-9924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-18
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-143461363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-143461OtherRN LICENSE