Provider Demographics
NPI:1114688264
Name:HARTSOCH, KASAUNDRE
Entity Type:Individual
Prefix:MRS
First Name:KASAUNDRE
Middle Name:
Last Name:HARTSOCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CAREY AVE
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-4309
Mailing Address - Country:US
Mailing Address - Phone:307-622-6137
Mailing Address - Fax:
Practice Address - Street 1:500 CAREY AVE
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-4309
Practice Address - Country:US
Practice Address - Phone:307-622-6137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-30
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion