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NPI Code Detail

MEDICARE: MS. MARYANN HART FNP

MEDICARE: MS. MARYANN HART FNP
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
1363LF0000XFamily Nurse Practitioner306174CA

General Provider Information

NPI Number : 1730163791
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARYANN HART FNP
Provider Business Mailing Address
First Line : 10470 OLD PLACERVILLE RD
Second Line : SUITE 100
City : SACRAMENTO
State : CA
Zip : 95827-2539
Country : US
Telephone Number : 800-470-0071
Fax Number :
Provider Business Practice Location Address
First Line : 2751 DEL PASO RD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95835-2303
Country : US
Telephone Number : 916-453-5141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 11/11/2013

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