Individual
AILEEN LARDIS
Active
Individual
AILEEN LARDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R175578
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
772153600
—
MD
01
—
791003
MEDICARE
MD
01
—
792305
MEDICARE
MD
01
—
CY310018
BCBS
MD
Enumeration date
01/31/2019
Last updated
12/23/2024
Update your record
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