Individual
BECKY MICHELLE HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1501 IMPERIAL AVE, SAN DIEGO, CA 92101-7638
(619) 233-8500
Mailing address
3238 GRANADA AVE, SAN DIEGO, CA 92104-4514
(619) 379-7043
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95025699
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95025699
BRN NURSE PRACTITIONER LICENSE #
CA
Enumeration date
07/17/2023
Last updated
07/17/2023
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