Provider Demographics
NPI:1114459724
Name:HARTBERG, COURTNEY ANN (CRNA, RN)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:ANN
Last Name:HARTBERG
Suffix:
Gender:F
Credentials:CRNA, RN
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Mailing Address - Street 1:1750 N JONES BLVD
Mailing Address - Street 2:UNIT 1
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-8825
Mailing Address - Country:US
Mailing Address - Phone:515-979-7162
Mailing Address - Fax:
Practice Address - Street 1:5901 WESTOWN PKWY STE 210
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8297
Practice Address - Country:US
Practice Address - Phone:515-221-9222
Practice Address - Fax:515-221-0575
Is Sole Proprietor?:No
Enumeration Date:2017-04-02
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAD156059367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered