Provider Demographics
NPI:1346013851
Name:HARTMAN, JAMIE ELIZABETH
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:ELIZABETH
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5949 MAYBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-4549
Mailing Address - Country:US
Mailing Address - Phone:970-443-0755
Mailing Address - Fax:
Practice Address - Street 1:5949 MAYBROOK CIR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4549
Practice Address - Country:US
Practice Address - Phone:970-443-0755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program