Provider Demographics
NPI:1396469284
Name:HARDY, DANIEL S (APRN, PMHNP-BC,)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:S
Last Name:HARDY
Suffix:
Gender:M
Credentials:APRN, PMHNP-BC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-1725
Mailing Address - Country:US
Mailing Address - Phone:513-642-9241
Mailing Address - Fax:
Practice Address - Street 1:1124 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-1725
Practice Address - Country:US
Practice Address - Phone:513-642-9241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0032421363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health