Provider Demographics
NPI:1730624479
Name:HART, TAYLOR KRISTINE (APRN)
Entity type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:KRISTINE
Last Name:HART
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:KRISTINE
Other - Last Name:YOHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:420 DELAWARE ST SE
Mailing Address - Street 2:MMC 207
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0341
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 HARVARD ST SE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0363
Practice Address - Country:US
Practice Address - Phone:612-273-3045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-04
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5681363LF0000X
LA204404363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily