Provider Demographics
NPI:1063860211
Name:HART, MARCIE KNOX (DNP)
Entity type:Individual
Prefix:DR
First Name:MARCIE
Middle Name:KNOX
Last Name:HART
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:MARCIE
Other - Middle Name:JILL
Other - Last Name:KNOX-HART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2010 N 75TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85035-3247
Mailing Address - Country:US
Mailing Address - Phone:623-245-6695
Mailing Address - Fax:623-245-3582
Practice Address - Street 1:2010 N 75TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85035-3247
Practice Address - Country:US
Practice Address - Phone:623-245-6695
Practice Address - Fax:623-245-3582
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-27
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-3404363LF0000X
OHAPRN.CNP.023024363LF0000X
AZ322188363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily