Provider Demographics
NPI:1922895598
Name:HARDY, JESSE LEE
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:LEE
Last Name:HARDY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 ELLIOTT LEE WAY # 816
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-1538
Mailing Address - Country:US
Mailing Address - Phone:614-531-0739
Mailing Address - Fax:
Practice Address - Street 1:816 ELLIOTT LEE WAY # 816
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-1538
Practice Address - Country:US
Practice Address - Phone:614-531-0739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program