=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326026733
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KRISTEL MARLENA HART RN, CNS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/05/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1125 SE 6TH ST
-----------------------------------------------------
City | WILLMAR
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 320-235-4613
-----------------------------------------------------
Fax | 320-231-9141
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1770 1ST ST N
-----------------------------------------------------
City | WILLMAR
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 320-235-4613
-----------------------------------------------------
Fax | 320-231-9141
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 364SP0807X
-----------------------------------------------------
Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
-----------------------------------------------------
License Number | R-075272-7
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 364SP0809X
-----------------------------------------------------
Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
-----------------------------------------------------
License Number | R-075272-7
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------