Basic Information
| Provider Information | |||||||||
| NPI: | 1588999759 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARTMAN | ||||||||
| FirstName: | KATY | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 920 E SHERIDAN ST STE A | ||||||||
| Address2: | |||||||||
| City: | LARAMIE | ||||||||
| State: | WY | ||||||||
| PostalCode: | 820703868 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3074609039 | ||||||||
| FaxNumber: | 3074609041 | ||||||||
| Practice Location | |||||||||
| Address1: | 920 E SHERIDAN ST STE A | ||||||||
| Address2: | |||||||||
| City: | LARAMIE | ||||||||
| State: | WY | ||||||||
| PostalCode: | 820703868 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3074609039 | ||||||||
| FaxNumber: | 3074609041 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2009 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 8319A | WY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.