Provider Demographics
NPI:1689472805
Name:HARDIMAN, ANIYA L
Entity type:Individual
Prefix:
First Name:ANIYA
Middle Name:L
Last Name:HARDIMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 MILL VIEW CT APT 1B
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-7317
Mailing Address - Country:US
Mailing Address - Phone:317-507-9718
Mailing Address - Fax:
Practice Address - Street 1:4410 MILL VIEW CT APT 1B
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-7317
Practice Address - Country:US
Practice Address - Phone:317-507-9718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1930280019172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver