Individual
THERESA L HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GNP, ANP
Contact information
Practice address
6172 FAWN MEADOW ST, FARMINGTON, NY 14425-1115
(585) 329-1511
Mailing address
6172 FAWN MEADOW ST, FARMINGTON, NY 14425-1115
(585) 329-1511
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
305553-1
NY
363LG0600X
Gerontology Nurse Practitioner
Primary
F340698-1
NY
Other
Enumeration date
06/03/2008
Last updated
10/04/2010
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