Healthcare Provider Details

I. General information

NPI: 1396348470
Provider Name (Legal Business Name): DAKOTA RENEE HANGARTNER APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DAKOTA RENEE HANGARTNER MSN, APRN, FNP-C

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 OLD BLUEGRASS AVE
LOUISVILLE KY
40215-1168
US

IV. Provider business mailing address

1800 OLD BLUEGRASS AVE
LOUISVILLE KY
40215-1168
US

V. Phone/Fax

Practice location:
  • Phone: 502-361-2301
  • Fax:
Mailing address:
  • Phone: 502-303-5293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberF09200507
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3015189
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: