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General NPI Number Information
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NPI Number | 1063044386
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Entity Type | Individual
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Provider Name | SAMANTHA TAYLOR HART APRN
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Gender | Female
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Dates
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Enumeration Date | 02/05/2020
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 3330 SKOKIE VALLEY RD STE 200
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-1041
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Country | US
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Telephone | 847-386-7744
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Fax |
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Provider Business Mailing Address
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Address Line | 1637 SW ARBORWAY TER
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City | LEES SUMMIT
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State | MO
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Zip | 64082-5600
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Country | US
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Telephone | 847-386-7744
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 113068
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 113068
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 2023011052
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License Number State | MO
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