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Joanna Michelle Hardy

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

2117 Broadway Drive, Hattiesburg, MS 39402-3210

PECOS Enrollment

This provider is enrolled in PECOS as JOANNA HARDY.

Based on the most recent information from CMS, provider Joanna Michelle Hardy is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1174636195
Provider Type
Individual
Full Name
Hardy, Joanna Michelle
Credential
FNP

Gender
Female
Sole Proprietor
Yes
Enumeration Date
8/16/2006
Last Updated
2/24/2025

Contact Information

Practice Location

2117 Broadway Drive, Hattiesburg, MS 39402-3210

(601) 288-8050

(601) 288-8058

Mailing Location

2117 Broadway Drive, Hattiesburg, MS 39402-3210

(601) 288-8050

(601) 288-8058

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License R803993 Mississippi

Provider Identifiers

ID	Description	Issuer
ID 891010340	Description Medicaid	Issuer Unlisted Alabama
ID 09483506	Description Medicaid	Issuer Unlisted Mississippi

Joanna Michelle Hardy

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

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