Individual
MRS. JENNIE HARDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2110 OAK PARK BLVD, LAKE CHARLES, LA 70601-7864
(337) 377-2579
Mailing address
3708 NELSON RD, LAKE CHARLES, LA 70605-2412
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20120860
LA
Other
Enumeration date
04/04/2018
Last updated
04/04/2018
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