Healthcare Provider Details

I. General information

NPI: 1316293822
Provider Name (Legal Business Name): CAROL HARTMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROL MONTGOMERY

II. Dates (important events)

Enumeration Date: 08/02/2012
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

376 W 10TH AVE 791 PRIOR HALL
COLUMBUS OH
43210-1280
US

IV. Provider business mailing address

575 COPELAND MILL RD STE 1D
COLUMBUS OH
43081-8977
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-8305
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13711
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN341177
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: