Provider Demographics
NPI:1215585369
Name:HARTEL, ROSEMARIE DOMANQUE
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:DOMANQUE
Last Name:HARTEL
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 1:4 WAC PL
Mailing Address - Street 2:
Mailing Address - City:BELEN
Mailing Address - State:NM
Mailing Address - Zip Code:87002-8185
Mailing Address - Country:US
Mailing Address - Phone:505-861-5541
Mailing Address - Fax:
Practice Address - Street 1:4 WAC PL
Practice Address - Street 2:
Practice Address - City:BELEN
Practice Address - State:NM
Practice Address - Zip Code:87002-8185
Practice Address - Country:US
Practice Address - Phone:505-861-5541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider