MEDICARE: JEANNETTE STUART HART PA-C

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	363A00000X	Physician Assistant	AP60316098	WA

General Provider Information

NPI Number	:	1962753830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNETTE STUART HART PA-C

Provider Business Mailing Address
First Line	:	1305 FOWLER ST STE 1D
Second Line	:
City	:	RICHLAND
State	:	WA
Zip	:	99352-4719
Country	:	US
Telephone Number	:	509-940-2284
Fax Number	:	509-940-2286

Provider Business Practice Location Address
First Line	:	1305 FOWLER ST STE 1D
Second Line	:
City	:	RICHLAND
State	:	WA
Zip	:	99352-4719
Country	:	US
Telephone Number	:	509-940-2284
Fax Number	:	509-940-2286

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

Provider Enumeration Date	:	10/01/2012
Last Update Date	:	08/18/2025

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