Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 20751 | TN |
NPI | 1003266867 |
---|---|
Provider Name | Andrea Lynn Hardison |
First Address | Brentwood, TN 37027-7416 |
Second Address | Nashville, TN 37204-3956 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2016 |
Last Update Date | 13/06/2016 |