Individual
JUDY A HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
1454 E 2ND ST, SAN BERNARDINO, CA 92408-0118
(909) 382-7100
Mailing address
39277 HARRIS RD, YUCAIPA, CA 92399-9405
(909) 797-2450
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
Primary
NP7766
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164735
RN LICENSE
CA
01
—
NP7766
NP LICENSE
CA
Enumeration date
03/06/2007
Last updated
07/08/2007
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