Provider Demographics
NPI:1972890101
Name:HART, KAREN A (APRN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:HART
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 29TH ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-3021
Mailing Address - Country:US
Mailing Address - Phone:606-325-7500
Mailing Address - Fax:606-326-9136
Practice Address - Street 1:933 29TH STREET
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101
Practice Address - Country:US
Practice Address - Phone:606-325-7500
Practice Address - Fax:606-326-9136
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-08
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007005364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health