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General NPI Number Information
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NPI Number | 1811635923
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Entity Type | Individual
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Provider Name | KATIE ELLEN HART AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/27/2022
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 1070 SMITH GROVE RD
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City | SCOTTSVILLE
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State | KY
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Zip | 42164-9444
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Country | US
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Telephone | 270-239-6024
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Fax | 270-239-6099
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Provider Business Mailing Address
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Address Line | 3112B HIGH RIDGE DR
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City | LEXINGTON
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State | KY
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Zip | 40517-4052
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Country | US
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Telephone | 270-589-0929
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 3017750
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License Number State | KY
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