Provider Demographics
NPI:1932609989
Name:HART, NICOLE YVETT (LVN)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:YVETT
Last Name:HART
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5275 TOWN AND COUNTRY BLVD APT 1445
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6240
Mailing Address - Country:US
Mailing Address - Phone:325-899-1145
Mailing Address - Fax:
Practice Address - Street 1:5275 TOWN AND COUNTRY BLVD APT 1445
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6240
Practice Address - Country:US
Practice Address - Phone:325-899-1145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX328044164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse