| Hardy House Your Family Healthcare Provider, Pllc | |
|
2747 Bartlett Blvd Bartlett TN 38134-4580 | |
| (901) 748-5308 | |
| (901) 529-7716 |
| Full Name | Hardy House Your Family Healthcare Provider, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2747 Bartlett Blvd, Bartlett, Tennessee |
| Authorized Official Name and Position | Latonya S Hardy (DOCTOR OF NURSING PRACTICE/OWNER) |
| Authorized Official Contact | 9017485308 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hardy House Your Family Healthcare Provider, Pllc 4165 Pine Hill Cv N Lakeland TN 38002-8111 Ph: (901) 229-1787 | Hardy House Your Family Healthcare Provider, Pllc 2747 Bartlett Blvd Bartlett TN 38134-4580 Ph: (901) 748-5308 |
| NPI Number | 1053961318 |
|---|---|
| Provider Enumeration Date | 09/18/2019 |
| Last Update Date | 09/18/2019 |
| Medicare PECOS PAC ID | 8527390780 |
|---|---|
| Medicare Enrollment ID | O20191022000627 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053961318 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Latonya Simone Hardy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376963041 PECOS PAC ID: 6901024462 Enrollment ID: I20140825001374 |
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