MEDICARE: AMANDA HARTMAN FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	7838431-4405	UT

General Provider Information

NPI Number	:	1356299457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA HARTMAN FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 125
Second Line	:
City	:	ALTAMONT
State	:	UT
Zip	:	84001-0125
Country	:	US
Telephone Number	:	435-799-8888
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 N MAIN ST
Second Line	:
City	:	ROOSEVELT
State	:	UT
Zip	:	84066-3024
Country	:	US
Telephone Number	:	435-799-8888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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Directions to “ AMANDA HARTMAN FNP-C” Practice Location

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