Individual
SHARDAI M HACKWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
565 OLD FARM RD, COLUMBUS, OH 43213-2663
(870) 397-0395
Mailing address
565 OLD FARM RD, COLUMBUS, OH 43213-2663
(870) 397-0395
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
440649
OH
Other
Enumeration date
10/05/2023
Last updated
09/11/2025
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