Provider Demographics
NPI:1669264131
Name:HARDIN, BRANDY TENNILLE (PT)
Entity type:Individual
Prefix:MS
First Name:BRANDY
Middle Name:TENNILLE
Last Name:HARDIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1270 ISLE POINTE DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-9007
Mailing Address - Country:US
Mailing Address - Phone:901-336-6430
Mailing Address - Fax:
Practice Address - Street 1:1270 ISLE POINTE DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-9007
Practice Address - Country:US
Practice Address - Phone:901-336-6430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000006210225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist