Provider Demographics
NPI:1386256725
Name:HARTMAN, CURTIS JONATHAN (NP-C)
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:JONATHAN
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 SPUR RD
Mailing Address - Street 2:
Mailing Address - City:OROFINO
Mailing Address - State:ID
Mailing Address - Zip Code:83544-6310
Mailing Address - Country:US
Mailing Address - Phone:208-476-5832
Mailing Address - Fax:
Practice Address - Street 1:359 SPUR RD
Practice Address - Street 2:
Practice Address - City:OROFINO
Practice Address - State:ID
Practice Address - Zip Code:83544-6310
Practice Address - Country:US
Practice Address - Phone:208-476-5832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID65501363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily