Provider Demographics
NPI:1033304746
Name:HARTMAN, LOIS MARIE (APRN, BC)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:MARIE
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 ASHFIELD ST
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26750-1300
Mailing Address - Country:US
Mailing Address - Phone:304-355-2323
Mailing Address - Fax:304-355-2903
Practice Address - Street 1:122 ASHFIELD ST
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:WV
Practice Address - Zip Code:26750-1300
Practice Address - Country:US
Practice Address - Phone:304-355-2323
Practice Address - Fax:304-355-2903
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV62945363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV62945OtherSTATE LICENSE