| NPI | 1558867606 | 
|---|---|
| Former Name | LENEA RAE HARDIMAN | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704230460)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704230460)  | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704230460)  | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704230460)  | |
| Enumeration Date | 2018-04-05 | 
| Last Update Date | 2023-02-01 |