Healthcare Provider Details

I. General information

NPI: 1134023674
Provider Name (Legal Business Name): HART MEDICAL WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22441 E CATTLE DR
QUEEN CREEK AZ
85142-4381
US

IV. Provider business mailing address

22441 E CATTLE DR
QUEEN CREEK AZ
85142-4381
US

V. Phone/Fax

Practice location:
  • Phone: 740-591-4966
  • Fax:
Mailing address:
  • Phone: 740-591-4966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOHN HART
Title or Position: OWNER
Credential: DNP, APRN-CNP
Phone: 740-591-4966