Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 29519 | KY |
NPI | 1033177431 |
---|---|
Provider Name | Kristina Jan Hartman |
First Address | Huntington, WV 25704-9588 |
Second Address | Huntington, WV 25704-9588 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 08/07/2007 |