Healthcare Provider Details

I. General information

NPI: 1861476582
Provider Name (Legal Business Name): DEBRA JEAN HARTIG RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2787 EUREKA WAY
REDDING CA
96001-0224
US

IV. Provider business mailing address

PO BOX 324 15828 CLODHOPPER DR
SHASTA CA
96087-0324
US

V. Phone/Fax

Practice location:
  • Phone: 530-243-1552
  • Fax: 530-243-0916
Mailing address:
  • Phone: 530-246-7126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN227667
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: