Individual
JENNIFER HARDIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3050 MACK RD, ML 11032, FAIRFIELD, OH 45014-5379
(513) 636-8259
(513) 636-6419
Mailing address
3050 MACK RD, ML 11032, FAIRFIELD, OH 45014-5379
(513) 636-8259
(513) 636-6419
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
32418
KY
208000000X
Pediatrics Physician
Primary
35.068552
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000034012
ANTHEM
KY
05
—
64060072
—
KY
01
—
K32418
CHOICE CARE
KY
Enumeration date
07/12/2005
Last updated
08/11/2015
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