Healthcare Provider Details

I. General information

NPI: 1720111693
Provider Name (Legal Business Name): JOAN-MARIE LARTIN PHD, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 S HANOVER ST
CARLISLE PA
17013-4103
US

IV. Provider business mailing address

614 S HANOVER ST
CARLISLE PA
17013-4103
US

V. Phone/Fax

Practice location:
  • Phone: 717-258-5915
  • Fax: 717-486-0087
Mailing address:
  • Phone: 717-258-5915
  • Fax: 717-486-0087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number237678-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: