Individual provider Active NPI

Andrea S Hardesty, ARNP

  • Gerontology Nurse Practitioner
  • Anacortes, WA
National Provider Identifier
1609944743
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP61428157 Issued in WA
Practice address
1902 Bradley Dr
Anacortes, WA 98221-3010
Phone
(425) 445-0600
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA00011129 WA
Gerontology Nurse Practitioner 363LG0600X AP61428157 WA Primary

Addresses

Primary practice location

1902 Bradley Dr
Anacortes, WA 98221-3010

Mailing address

1902 Bradley Dr
Anacortes, WA 98221-3010
Phone (425) 445-0600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA00011129WAMDSpecialist
AP61428157WAMDGerontology Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1609944743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 BRADLEY DR",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982213010",
            "telephone_number": "425-445-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 BRADLEY DR",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982213010",
            "telephone_number": "425-445-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDESTY",
        "first_name": "ANDREA",
        "middle_name": "S",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00011129",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP61428157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anacortes, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.