Individual
REGINA RUBYANN HARDESTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
200 S ENOTA DR NE STE 100, GAINESVILLE, GA 30501-3466
(770) 868-5184
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN211580
GA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN211580
GA
363LG0600X
Gerontology Nurse Practitioner
RN211580
GA
Other
Enumeration date
02/12/2021
Last updated
06/30/2023
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