Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 18064 | MS |
NPI | 1104869148 |
---|---|
Provider Name | Dr. Natasha N Hardeman |
First Address | Flowood, MS 39232-7640 |
Second Address | Flowood, MS 39232-7640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 19/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07926573 | (05) | MS |
H48450 | (02) | MS |