Provider Demographics
NPI:1063566057
Name:HARTUNG, NANCY (RN)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:HARTUNG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 6TH AVE SE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-4900
Mailing Address - Country:US
Mailing Address - Phone:605-225-1538
Mailing Address - Fax:605-229-2053
Practice Address - Street 1:1315 6TH AVE SE
Practice Address - Street 2:SUITE 6
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-4900
Practice Address - Country:US
Practice Address - Phone:605-225-1538
Practice Address - Fax:605-229-2053
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR027005163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5350182Medicaid