MEDICARE: PAMELA M HART APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	11015710	FL

General Provider Information

NPI Number	:	1225700909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA M HART APRN

Provider Business Mailing Address
First Line	:	739 S SPRING GARDEN AVE
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32720-6691
Country	:	US
Telephone Number	:	386-777-2273
Fax Number	:

Provider Business Practice Location Address
First Line	:	739 S SPRING GARDEN AVE
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32720-6691
Country	:	US
Telephone Number	:	386-777-2273
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2021
Last Update Date	:	04/17/2026

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Directions to “ PAMELA M HART APRN” Practice Location

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