Individual
NICOLE KATHARINE HARDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5700 COOPER FOSTER PARK RD W, LORAIN, OH 44053-4140
(440) 204-7220
Mailing address
311 CRESTMONT CIR, AVON LAKE, OH 44012-3150
(440) 258-2530
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.003435
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50.003435
OHIO STATE MEDICAL BOARD, PHYSICIAN ASSISTANT LICENSE
OH
Enumeration date
01/26/2012
Last updated
01/09/2017
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