Provider Demographics
NPI:1588265367
Name:HARDESTY, MELISSA (STNA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:HARDESTY
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 RAYMOND DR
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-1277
Mailing Address - Country:US
Mailing Address - Phone:330-509-8736
Mailing Address - Fax:
Practice Address - Street 1:269 RAYMOND DR
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OH
Practice Address - Zip Code:44425-1277
Practice Address - Country:US
Practice Address - Phone:330-509-8736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide