Provider Demographics
NPI:1619633385
Name:HART, LAUREN BETHANY (DNP APRN)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:BETHANY
Last Name:HART
Suffix:
Gender:F
Credentials:DNP APRN
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:BETHANY
Other - Last Name:EASTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1308 E PAGE AVE
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:AR
Mailing Address - Zip Code:72104-4518
Mailing Address - Country:US
Mailing Address - Phone:501-337-9820
Mailing Address - Fax:501-468-0478
Practice Address - Street 1:1308 E PAGE AVE
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104-4518
Practice Address - Country:US
Practice Address - Phone:501-337-9820
Practice Address - Fax:501-468-0478
Is Sole Proprietor?:No
Enumeration Date:2021-11-16
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR216941363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care