Provider Demographics
NPI:1326278938
Name:HART, SHEILA LYNN (RN)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:LYNN
Last Name:HART
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:SHEILA
Other - Middle Name:LYNN
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1101 DRAKES COVE RD N
Mailing Address - Street 2:
Mailing Address - City:ADAMS
Mailing Address - State:TN
Mailing Address - Zip Code:37010-8036
Mailing Address - Country:US
Mailing Address - Phone:931-358-6438
Mailing Address - Fax:
Practice Address - Street 1:650 JOEL DR
Practice Address - Street 2:
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223-5318
Practice Address - Country:US
Practice Address - Phone:270-956-0489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1114709163WG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0100XNursing Service ProvidersRegistered NurseGastroenterology