Provider Demographics
NPI:1275412090
Name:HART, DOUG (RN)
Entity type:Individual
Prefix:
First Name:DOUG
Middle Name:
Last Name:HART
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5145 PARKVALLEY CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-1905
Mailing Address - Country:US
Mailing Address - Phone:513-615-0157
Mailing Address - Fax:
Practice Address - Street 1:4350 MALSBARY RD
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-5665
Practice Address - Country:US
Practice Address - Phone:513-751-2273
Practice Address - Fax:513-751-1848
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.396031163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse