Healthcare Provider Details

I. General information

NPI: 1053414276
Provider Name (Legal Business Name): KAREN ELIZABETH HARTMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5362 WILLOW CREST AVE
YOUNGSTOWN OH
44515-4048
US

IV. Provider business mailing address

5362 WILLOW CREST AVE
YOUNGSTOWN OH
44515-4048
US

V. Phone/Fax

Practice location:
  • Phone: 330-318-3520
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: