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General NPI Number Information
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NPI Number | 1821981655
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Entity Type | Organization
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Legal Business Name | HART PEDIATRICS
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 6700 JEFFERSON ST NE STE A-1
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4382
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Country | US
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Telephone | 505-385-8167
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Fax |
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Provider Business Mailing Address
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Address Line | 7513 LAMPLIGHTER LN NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-3218
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Country | US
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Telephone | 505-385-8167
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | KIMBERLY A HART
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Credential | CPNP
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Telephone | 505-385-8167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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