Basic Information
Provider Information
NPI: 1902155104
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARTMAN
FirstName: KATHLEEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: C.R.N.P.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1200 OLD YORK RD
Address2: AMBULATORY SERVICES
City: ABINGTON
State: PA
PostalCode: 190013720
CountryCode: US
TelephoneNumber: 2154812180
FaxNumber: 2154813411
Practice Location
Address1: 1200 OLD YORK RD
Address2: AMBULATORY SERVICES
City: ABINGTON
State: PA
PostalCode: 190013720
CountryCode: US
TelephoneNumber: 2154812180
FaxNumber: 2154813411
Other Information
ProviderEnumerationDate: 09/04/2012
LastUpdateDate: 09/04/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200XSP012312PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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