Provider Demographics
NPI:1780923680
Name:HARDY, JOANNE (RN)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:HARDY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:
Other - Last Name:AKONOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3775 GEORGIA ST APT 203
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-7607
Mailing Address - Country:US
Mailing Address - Phone:619-504-4267
Mailing Address - Fax:
Practice Address - Street 1:730 MEDICAL CENTER CT
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6618
Practice Address - Country:US
Practice Address - Phone:619-397-6913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA438551163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse