Provider Demographics
NPI:1700874930
Name:HART, NANCY BORJA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:BORJA
Last Name:HART
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 LONG HOLLOW PIKE
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3480
Mailing Address - Country:US
Mailing Address - Phone:615-851-8436
Mailing Address - Fax:
Practice Address - Street 1:460 LONG HOLLOW PIKE
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-3480
Practice Address - Country:US
Practice Address - Phone:615-851-8436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL40202183500000X
TN37195183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist