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General NPI Number Information
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NPI Number | 1184814923
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Entity Type | Individual
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Provider Name | MARY ALEXANDRA HARTMAN APRN
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Gender | Female
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 85 LAFAYETTE ST
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City | NEW BRITAIN
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State | CT
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Zip | 06051-1803
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Country | US
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Telephone | 860-224-3642
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Fax |
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Provider Business Mailing Address
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Address Line | 22 SOUTH GREEN STREET
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City | BALTIMORE
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State | MD
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Zip | 21201
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R164047
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 13819
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R164047
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License Number State | MD
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