Individual
VICTORIA JACOBSEN HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2390 W CONGRESS ST, LAFAYETTE, LA 70506-4205
(337) 261-8526
Mailing address
302 SYLVESTER DR, YOUNGSVILLE, LA 70592-6656
(337) 298-0227
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
200893
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200893
LIC
LA
Enumeration date
09/30/2015
Last updated
07/13/2022
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