Provider Demographics
NPI:1629942479
Name:HART, LAWRENCE MICHAEL
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:MICHAEL
Last Name:HART
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 HORSESHOE CIR
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-3812
Mailing Address - Country:US
Mailing Address - Phone:402-960-3642
Mailing Address - Fax:
Practice Address - Street 1:1107 HORSESHOE CIR
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-3812
Practice Address - Country:US
Practice Address - Phone:402-960-3642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty