Provider Demographics
NPI:1578153094
Name:HART, EMILY D (FNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:D
Last Name:HART
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 REID PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1157
Mailing Address - Country:US
Mailing Address - Phone:765-962-9541
Mailing Address - Fax:765-966-5952
Practice Address - Street 1:1050 REID PKWY STE 220
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1160
Practice Address - Country:US
Practice Address - Phone:765-962-9541
Practice Address - Fax:765-966-5952
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-19
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71010832A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily