Basic Information
Provider Information
NPI: 1659749471
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARDY
FirstName: KRISTINA
MiddleName: C
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 67250
Address2:  
City: LINCOLN
State: NE
PostalCode: 685067250
CountryCode: US
TelephoneNumber: 4024136706
FaxNumber: 8889650959
Practice Location
Address1: 7440 S 91ST ST
Address2:  
City: LINCOLN
State: NE
PostalCode: 685269797
CountryCode: US
TelephoneNumber: 4023272700
FaxNumber: 4023283716
Other Information
ProviderEnumerationDate: 09/10/2015
LastUpdateDate: 03/02/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X111817NEY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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