Provider Demographics
NPI:1154177756
Name:HART, EMILY JESSICA (FNP-C, CSCS)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:JESSICA
Last Name:HART
Suffix:
Gender:F
Credentials:FNP-C, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5361
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-0461
Mailing Address - Country:US
Mailing Address - Phone:703-237-1059
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 5361
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-0461
Practice Address - Country:US
Practice Address - Phone:703-237-1059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024189263363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care