MEDICARE: DIANA HART

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide	2702516	OH

General Provider Information

NPI Number	:	1164644712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA HART

Provider Business Mailing Address
First Line	:	685 ST.RT.83
Second Line	:
City	:	BEVERLY
State	:	OH
Zip	:	45715
Country	:	US
Telephone Number	:	740-558-2105
Fax Number	:

Provider Business Practice Location Address
First Line	:	963 TICK HILL RD
Second Line	:
City	:	LOWELL
State	:	OH
Zip	:	45744-7486
Country	:	US
Telephone Number	:	740-525-3415
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	07/08/2007

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Directions to “ DIANA HART ” Practice Location

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