Provider Demographics
NPI:1144348079
Name:HARDER, STEPHANIE LYNN (CPNP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LYNN
Last Name:HARDER
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 S MILES AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-5439
Mailing Address - Country:US
Mailing Address - Phone:731-885-4338
Mailing Address - Fax:731-885-4339
Practice Address - Street 1:1117 S MILES AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-5439
Practice Address - Country:US
Practice Address - Phone:731-885-4338
Practice Address - Fax:731-885-4339
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN148510163WP0200X
TNAPN12637363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics