Healthcare Provider Details

I. General information

NPI: 1326278938
Provider Name (Legal Business Name): SHEILA LYNN HART RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHEILA LYNN HART RN

II. Dates (important events)

Enumeration Date: 07/16/2009
Last Update Date: 07/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 JOEL DR
FORT CAMPBELL KY
42223-5318
US

IV. Provider business mailing address

1101 DRAKES COVE RD N
ADAMS TN
37010-8036
US

V. Phone/Fax

Practice location:
  • Phone: 270-956-0489
  • Fax:
Mailing address:
  • Phone: 931-358-6438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0100X
TaxonomyGastroenterology Registered Nurse
License Number1114709
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: