Healthcare Provider Details

I. General information

NPI: 1871877563
Provider Name (Legal Business Name): KARA L HARTMAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2011
Last Update Date: 11/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 MERIDIAN ST SO STE A
PUYALLUP WA
98371
US

IV. Provider business mailing address

1901 MERIDIAN ST SO STE A
PUYALLUP WA
98371
US

V. Phone/Fax

Practice location:
  • Phone: 253-848-2303
  • Fax:
Mailing address:
  • Phone: 253-848-2303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60355500
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number12586-NP
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP60355500
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number359149
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: