Provider Demographics
NPI:1962617498
Name:HARDMAN, MARIE KING (RN)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:KING
Last Name:HARDMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 MECHANIC ST
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-2843
Mailing Address - Country:US
Mailing Address - Phone:207-632-9197
Mailing Address - Fax:
Practice Address - Street 1:112 MECHANIC ST
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-2843
Practice Address - Country:US
Practice Address - Phone:207-632-9197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT367172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist