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NPI Code Detail

MEDICARE: HART SOUL & MIND HEALTHCARE, LLC

MEDICARE: HART SOUL & MIND HEALTHCARE, LLC
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
1363LP2300XPrimary Care Nurse Practitioner
2363LP0808XPsychiatric/Mental Health Nurse Practitioner
3363L00000XNurse Practitioner

General Provider Information

NPI Number : 1538903117
Entity Type Code : Organization
Provider Name (Legal Business Name) : HART SOUL & MIND HEALTHCARE, LLC
Provider Business Mailing Address
First Line : 4770 INDIANOLA AVE STE 210
Second Line :
City : COLUMBUS
State : OH
Zip : 43214-1862
Country : US
Telephone Number : 614-306-4477
Fax Number : 614-862-0837
Provider Business Practice Location Address
First Line : 4770 INDIANOLA AVE STE 210
Second Line :
City : COLUMBUS
State : OH
Zip : 43214-1862
Country : US
Telephone Number : 614-306-4477
Fax Number : 614-862-0837
Authorized Official
Title or Position : APRN
Name : MRS. CONSTANCE R HARTGROVE
Credential : APRN
Telephone Number : 614-306-4477
Provider Enumeration Date : 06/19/2024
Last Update Date : 06/21/2026

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Directions to “HART SOUL & MIND HEALTHCARE, LLC ” Practice Location

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