Provider Demographics
NPI:1467650184
Name:HART HEALTHCARE, PLLC
Entity type:Organization
Organization Name:HART HEALTHCARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RONDA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:859-640-5377
Mailing Address - Street 1:4467 HACKBERRY CT
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41005-6904
Mailing Address - Country:US
Mailing Address - Phone:859-640-5377
Mailing Address - Fax:859-689-0320
Practice Address - Street 1:4467 HACKBERRY CT
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:KY
Practice Address - Zip Code:41005-6904
Practice Address - Country:US
Practice Address - Phone:859-640-5377
Practice Address - Fax:859-689-0320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7018363LF0000X
IN71001636A363LF0000X
KY3713P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7949Medicare PIN
KY7948Medicare PIN
KY7947Medicare PIN