Provider Demographics
NPI:1225250004
Name:HARTSHORN HEALTH CENTER
Entity Type:Organization
Organization Name:HARTSHORN HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:R.N. B.S.N.
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:OLSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-416-1996
Mailing Address - Street 1:4459 EAGLE LK S
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-8609
Mailing Address - Country:US
Mailing Address - Phone:970-416-1996
Mailing Address - Fax:
Practice Address - Street 1:HARTSHORN HEALTH CTR
Practice Address - Street 2:COLORADO STATE UNIVERSITY
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80523-0001
Practice Address - Country:US
Practice Address - Phone:970-491-7121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO111417261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health