Healthcare Provider Details

I. General information

NPI: 1952455636
Provider Name (Legal Business Name): LINDA DIANE HART RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36000 DARNALL LOOP
FORT HOOD TX
76544-5095
US

IV. Provider business mailing address

279 WYATT EARP LOOP
NOLANVILLE TX
76559-9755
US

V. Phone/Fax

Practice location:
  • Phone: 254-286-7825
  • Fax: 254-286-7479
Mailing address:
  • Phone: 254-286-7825
  • Fax: 254-286-7479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number634253
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: