Individual
MS. KELLY RENEE HARDESTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
703 N MAIN ST, KOUTS, IN 46347-9692
(219) 766-3131
Mailing address
401 ROSS AVE, KOUTS, IN 46347-9560
(219) 678-7714
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28187389A
IN
Other
Enumeration date
08/03/2017
Last updated
08/03/2017
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