Provider Demographics
NPI:1841423530
Name:HARDMAN, RANDI D (PA-C)
Entity type:Individual
Prefix:
First Name:RANDI
Middle Name:D
Last Name:HARDMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:RANDI
Other - Middle Name:D
Other - Last Name:HAUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:12200 W 106TH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2305
Mailing Address - Country:US
Mailing Address - Phone:913-541-5500
Mailing Address - Fax:913-541-7474
Practice Address - Street 1:12200 W 106TH ST STE 400
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2305
Practice Address - Country:US
Practice Address - Phone:913-541-5500
Practice Address - Fax:914-541-7474
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-01339363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1023274404Medicaid