MEDICARE: JENNIFER LEE HART CRNA

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	367500000X	Certified Registered Nurse Anesthetist	ARNP3165582	FL
2	163W00000X	Registered Nurse	940753	NY
3	367500000X	Certified Registered Nurse Anesthetist	28276846A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447244058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LEE HART CRNA

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 N SENATE BLVD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-1239
Country	:	US
Telephone Number	:	317-577-4200
Fax Number	:	317-577-9503

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

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	03/27/2026

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