Provider Demographics
NPI:1992181531
Name:HARDWICK, TRISHA
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:
Last Name:HARDWICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 N WASILLA FISHHOOK RD
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-4009
Mailing Address - Country:US
Mailing Address - Phone:907-631-9287
Mailing Address - Fax:
Practice Address - Street 1:2101 N WASILLA FISHHOOK RD
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-4009
Practice Address - Country:US
Practice Address - Phone:907-631-9287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK38619163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse