Individual
ANGELA J HARDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10 NORTH 3RD AVENUE, MC RAE, GA 31055
(229) 868-2831
Mailing address
10 NORTH 3RD AVENUE, MC RAE, GA 31055
(229) 868-2831
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2414
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2414
PA LICENSE
GA
Enumeration date
11/18/2015
Last updated
11/18/2015
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