Provider Demographics
NPI:1578817896
Name:HART, ALANA C (NP)
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:C
Last Name:HART
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ALANA
Other - Middle Name:C
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2705 N LEBANON ST STE 305
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052-8622
Mailing Address - Country:US
Mailing Address - Phone:765-485-8852
Mailing Address - Fax:
Practice Address - Street 1:2505 N LEBANON ST STE 220
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:IN
Practice Address - Zip Code:46052
Practice Address - Country:US
Practice Address - Phone:765-485-8740
Practice Address - Fax:765-485-8749
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004180A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201121260Medicaid
IN201121260Medicaid
IN267030006Medicare PIN