Healthcare Provider Details

I. General information

NPI: 1841757119
Provider Name (Legal Business Name): ANN HART PMH NP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2019
Last Update Date: 02/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

867 WASHINGTON ST
RALEIGH NC
27605-1255
US

IV. Provider business mailing address

1209 CEDAR CREEK DR
CARY NC
27513-4948
US

V. Phone/Fax

Practice location:
  • Phone: 919-833-5869
  • Fax: 919-833-5859
Mailing address:
  • Phone: 919-274-8232
  • Fax: 919-882-1512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANN LEICHTLE HART
Title or Position: OWNER
Credential: PMH NP
Phone: 919-274-8232