Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRN.CNP.026526 | OH |
NPI | 1518593730 |
---|---|
Provider Name | Scott Michael Hartman |
First Address | Oberlin, OH 44074-9627 |
Second Address | Elyria, OH 44035 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2020 |
Last Update Date | 19/03/2020 |