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NPI Code Detail

MEDICARE: MARISSA MARIE HARTMAN FNP

MEDICARE: MARISSA MARIE HARTMAN FNP
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
1363LF0000XFamily Nurse Practitioner205508LA

General Provider Information

NPI Number : 1619861721
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA MARIE HARTMAN FNP
Provider Business Mailing Address
First Line : 126 DILLON DR
Second Line :
City : SLIDELL
State : LA
Zip : 70461-4239
Country : US
Telephone Number : 504-919-3850
Fax Number :
Provider Business Practice Location Address
First Line : 1389 LAKEWOOD DR STE B
Second Line :
City : SLIDELL
State : LA
Zip : 70458-3127
Country : US
Telephone Number : 504-919-3850
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2025
Last Update Date : 06/04/2025

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Directions to “ MARISSA MARIE HARTMAN FNP” Practice Location

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