Provider Demographics
NPI:1174924708
Name:HARDWAY, JESSICA ANN (APRN-FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ANN
Last Name:HARDWAY
Suffix:
Gender:F
Credentials:APRN-FNP-C
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ANN
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:501 MORRIS ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-1326
Mailing Address - Country:US
Mailing Address - Phone:304-388-7256
Mailing Address - Fax:304-388-6009
Practice Address - Street 1:501 MORRIS ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1326
Practice Address - Country:US
Practice Address - Phone:304-388-7256
Practice Address - Fax:304-388-6009
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN91011-NP-C363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVAPRN91011-NP-COtherOTHER