Provider Demographics
NPI:1366756967
Name:HARDEN, IVY N (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:IVY
Middle Name:N
Last Name:HARDEN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:IVY
Other - Middle Name:N
Other - Last Name:WHALEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 4000
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37602-4000
Mailing Address - Country:US
Mailing Address - Phone:800-355-3565
Mailing Address - Fax:423-714-2355
Practice Address - Street 1:PO BOX 4000
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:TN
Practice Address - Zip Code:37684-4000
Practice Address - Country:US
Practice Address - Phone:865-573-0698
Practice Address - Fax:865-573-3174
Is Sole Proprietor?:No
Enumeration Date:2010-08-06
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN106158163W00000X
TN15095363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse