Individual
JENNIFER LYNN HARDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
245 FLEMINGSBURG RD, MOREHEAD, KY 40351-1015
(606) 780-5500
(606) 783-7281
Mailing address
405 CLINIC DR, MOREHEAD, KY 40351-1077
(606) 780-5500
(606) 783-7281
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA412
KY
363AM0700X
Medical Physician Assistant
PA412
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37903705
MEDICAID LAB GRP
KY
01
—
4000501
MEDICARE LAB GRP
KY
05
—
95000386
—
KY
01
—
CB5773
RR MEDICARE GRP
GA
01
—
K032922
MEDICARE PTAN
KY
01
—
P00190999
RR MEDICARE PIN
GA
Enumeration date
10/03/2006
Last updated
05/02/2018
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