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NPI Code Detail

MEDICARE: MOLLY HARTMAN CRNA

MEDICARE: MOLLY HARTMAN CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist101518NE

General Provider Information

NPI Number : 1063978492
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY HARTMAN CRNA
Provider Business Mailing Address
First Line : 7028 S MADISON WAY
Second Line :
City : CENTENNIAL
State : CO
Zip : 80122-1856
Country : US
Telephone Number : 303-204-1236
Fax Number :
Provider Business Practice Location Address
First Line : 2101 BOX BUTTE AVE
Second Line :
City : ALLIANCE
State : NE
Zip : 69301-4444
Country : US
Telephone Number : 308-762-6660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2019
Last Update Date : 05/09/2021

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