Individual
TRACI LYNN HARDYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6500 EXCELSIOR BLVD, DIGESTIVE & ENDOSCOPY CENTER, SUITE #4-820, ST LOUIS PARK, MN 55426-4702
(952) 993-3240
Mailing address
6500 EXCELSIOR BLVD, DIGESTIVE & ENDOSCOPY CENTER, SUITE #4-820, ST LOUIS PARK, MN 55426-4702
(952) 993-3240
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
CNP 4193
MN
363LG0600X
Gerontology Nurse Practitioner
Primary
CNP 4193
MN
Other
Enumeration date
10/21/2015
Last updated
10/21/2015
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