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NPI 1437932472

NPI 1437932472 : SARA ASHLEY HART : LEBANON, KY

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General NPI Number Information
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    NPI Number           |    1437932472
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    Entity Type          |    Individual 
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    Provider Name        |    SARA ASHLEY HART
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/15/2023
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    Last Update Date     |    08/15/2023
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Provider Practice Location Address
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    Address Line         |    705 E MAIN ST 
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    City                 |    LEBANON
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    State                |    KY
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    Zip                  |    40033-1701
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    Country              |    US
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    Telephone            |    859-692-2123
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    212 OLD FORT RD APT D 
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    City                 |    STANFORD
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    State                |    KY
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    Zip                  |    40484-9781
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    Country              |    US
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    Telephone            |    859-339-9879
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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        |    1835P0018X
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    Taxonomy Name        |    Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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    License Number       |    022790
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    License Number State |    KY
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