Provider Demographics
NPI:1225286131
Name:HARTMAN, JANE ELISE (DO)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:ELISE
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 SOUTH BRUCE STREET
Mailing Address - Street 2:AVERA MARSHALL
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-1934
Mailing Address - Country:US
Mailing Address - Phone:507-537-9007
Mailing Address - Fax:507-537-2730
Practice Address - Street 1:300 SOUTH BRUCE STREET
Practice Address - Street 2:AVERA MARSHALL
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-1934
Practice Address - Country:US
Practice Address - Phone:507-537-9007
Practice Address - Fax:507-537-2730
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2017-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN55074207Q00000X
PAOT012658207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine