Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | MD-7838 | HI |
NPI | 1043457294 |
---|---|
Provider Name | Dr. Jeanne Anne Hardie |
First Address | Lahaina, HI 96761-2916 |
Second Address | Lahaina, HI 96761-2916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2009 |
Last Update Date | 09/01/2009 |