Individual
MARYANN T HARDESTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
4545 E SHEA BLVD, PHOENIX, AZ 85028-3074
(602) 464-5200
Mailing address
3834 S SUNTREE WAY, BOISE, ID 83706-6906
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
272
ID
Other
Enumeration date
03/28/2006
Last updated
10/21/2010
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