Provider Demographics
NPI:1609394790
Name:HART, ELIZABETH MORTON (RN)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MORTON
Last Name:HART
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:3788 ROLLING RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24590-4229
Mailing Address - Country:US
Mailing Address - Phone:434-296-4557
Mailing Address - Fax:434-688-4138
Practice Address - Street 1:3788 ROLLING RD
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24590-4229
Practice Address - Country:US
Practice Address - Phone:434-296-4557
Practice Address - Fax:434-688-4138
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA1254065163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0329710831Medicaid