Provider Demographics
NPI:1811346539
Name:HARDESTY, TIA (APN-NP PMHNP-BC)
Entity type:Individual
Prefix:
First Name:TIA
Middle Name:
Last Name:HARDESTY
Suffix:
Gender:F
Credentials:APN-NP PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2480 S JEBEL WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-8999
Mailing Address - Country:US
Mailing Address - Phone:720-296-9744
Mailing Address - Fax:
Practice Address - Street 1:22422 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7267
Practice Address - Country:US
Practice Address - Phone:303-841-7857
Practice Address - Fax:303-209-7854
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-03
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0202553163WP0807X
COAPN.0993419-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & AdolescentGroup - Multi-Specialty