Individual
MR. JAMALE RICHARD HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
101 BODIN CIR, 60 MDG/SGIC, TRAVIS AFB, CA 94535-1809
(707) 423-3932
Mailing address
877 EMERALD HILLS CIR, FAIRFIELD, CA 94533-9787
(210) 837-2797
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP124527
TX
Other
Enumeration date
10/16/2013
Last updated
04/07/2017
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