Individual
WAUNTESHA HARDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
770 PARK EAST BLVD STE B, LAFAYETTE, IN 47905-0786
(765) 714-4344
Mailing address
770 PARK EAST BLVD STE B, LAFAYETTE, IN 47905-0786
(765) 714-4344
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
71007222A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300004440
—
IN
01
—
471400463
MEDICARE
IN
Enumeration date
06/20/2017
Last updated
06/02/2025
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