Provider Demographics
NPI:1316045560
Name:HART, CARLENA K (APRN,BC)
Entity Type:Individual
Prefix:MS
First Name:CARLENA
Middle Name:K
Last Name:HART
Suffix:
Gender:F
Credentials:APRN,BC
Other - Prefix:MS
Other - First Name:CARLENA
Other - Middle Name:K
Other - Last Name:FRANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN,BC
Mailing Address - Street 1:823 FLORA
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301
Mailing Address - Country:US
Mailing Address - Phone:928-445-4860
Mailing Address - Fax:
Practice Address - Street 1:NORTHERN ARIZONA VA HCS
Practice Address - Street 2:500 N HWY 89
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86313
Practice Address - Country:US
Practice Address - Phone:928-445-4860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6973363LA2200X
AZRN027329/APO1584363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health