Basic Information
Provider Information
NPI: 1053593939
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HART
FirstName: SARAH
MiddleName: F
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4848 WINDSOR VLG DR
Address2: #20
City: BATON ROUGE
State: LA
PostalCode: 708171380
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3510 N CAUSEWAY BLVD
Address2: SUITE 404
City: METAIRIE
State: LA
PostalCode: 700023531
CountryCode: US
TelephoneNumber: 5047795515
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/03/2007
LastUpdateDate: 12/03/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XRN103561LAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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