Provider Demographics
NPI:1447507017
Name:HARTMAN, AMANDA LYNN (APRN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNN
Last Name:HARTMAN
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 SE 10TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66607-1706
Mailing Address - Country:US
Mailing Address - Phone:785-783-8453
Mailing Address - Fax:785-783-8469
Practice Address - Street 1:2721 SE 10TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66607-1706
Practice Address - Country:US
Practice Address - Phone:785-783-8453
Practice Address - Fax:785-783-8469
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-75743-081363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSMB2693996OtherDEA
NV12436827OtherCAQH