Healthcare Provider Details

I. General information

NPI: 1336093194
Provider Name (Legal Business Name): TIFFANY HART CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S 7TH AVE STE 245
WEST READING PA
19611-1451
US

IV. Provider business mailing address

173 HECKMAN RD
TEMPLE PA
19560-9708
US

V. Phone/Fax

Practice location:
  • Phone: 610-781-2256
  • Fax:
Mailing address:
  • Phone: 610-781-2256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberSP036772
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: