Individual
MRS. VICKI ANN HARDISTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
503 MUIR ST STE A, CAMBRIDGE, MD 21613-1848
(410) 228-4045
(833) 908-2286
Mailing address
503 MUIR ST STE A, CAMBRIDGE, MD 21613-1848
(410) 228-4045
(339) 082-2688
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
LG-0000610
DE
363LF0000X
Family Nurse Practitioner
Primary
R156476
MD
Other
Enumeration date
03/16/2012
Last updated
10/29/2020
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