Healthcare Provider Details

I. General information

NPI: 1871119826
Provider Name (Legal Business Name): TARA HART APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TARA ANDERSON RN

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 05/01/2023
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1791 ALUM CREEK DR
COLUMBUS OH
43207-1708
US

IV. Provider business mailing address

1791 ALUM CREEK DR
COLUMBUS OH
43207-1708
US

V. Phone/Fax

Practice location:
  • Phone: 614-445-8131
  • Fax:
Mailing address:
  • Phone: 614-445-8131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0031477
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number355630
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: