Healthcare Provider Details

I. General information

NPI: 1437632585
Provider Name (Legal Business Name): LORA MARIE HART CPM, LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2018
Last Update Date: 04/13/2024
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 N. HIGH ST. SUITE 410
COLUMBUS OH
43214-2635
US

IV. Provider business mailing address

4400 N. HIGH ST. SUITE 410
COLUMBUS OH
43214-2635
US

V. Phone/Fax

Practice location:
  • Phone: 614-648-7735
  • Fax: 614-737-5777
Mailing address:
  • Phone: 614-648-7735
  • Fax: 614-737-5777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number534-49
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: