Provider Demographics
NPI:1982755393
Name:HART, LE TERA ANN (FNP)
Entity type:Individual
Prefix:MS
First Name:LE TERA
Middle Name:ANN
Last Name:HART
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:453 AUGUSTUS LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NC
Mailing Address - Zip Code:28120-7703
Mailing Address - Country:US
Mailing Address - Phone:216-385-7957
Mailing Address - Fax:
Practice Address - Street 1:453 AUGUSTUS LN
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NC
Practice Address - Zip Code:28120-7703
Practice Address - Country:US
Practice Address - Phone:216-385-7957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 118567164W00000X
NC5021811363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No164W00000XNursing Service ProvidersLicensed Practical Nurse