Healthcare Provider Details

I. General information

NPI: 1912827098
Provider Name (Legal Business Name): HART HEALTH & WELLNESS INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 TUCKER ST
JACKSON TN
38301-4092
US

IV. Provider business mailing address

100 SUMMERFIELD DR
MEDINA TN
38355-6863
US

V. Phone/Fax

Practice location:
  • Phone: 731-613-5101
  • Fax:
Mailing address:
  • Phone: 731-613-5101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANGELA HART
Title or Position: PROVIDER/OWNER
Credential: APRN, FNP-C
Phone: 731-613-5101