Healthcare Provider Details

I. General information

NPI: 1285949073
Provider Name (Legal Business Name): CHERI LYNN HARTMANN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHERI LYNN LARESE FNP-BC

II. Dates (important events)

Enumeration Date: 08/17/2010
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2179 SE OCEAN BLVD
STUART FL
34996-3305
US

IV. Provider business mailing address

2179 SE OCEAN BLVD
STUART FL
34996-3305
US

V. Phone/Fax

Practice location:
  • Phone: 772-301-6475
  • Fax: 772-301-6480
Mailing address:
  • Phone: 772-301-6475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP3068002
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: