Provider Demographics
NPI:1275587131
Name:HARTT, KRISTIN MG (MD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MG
Last Name:HARTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:MG
Other - Last Name:REISCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:194 E MAIN ST
Mailing Address - Street 2:FORT KENT
Mailing Address - City:FORT KENT
Mailing Address - State:ME
Mailing Address - Zip Code:04743-1428
Mailing Address - Country:US
Mailing Address - Phone:207-834-3155
Mailing Address - Fax:207-834-2949
Practice Address - Street 1:194 E MAIN ST
Practice Address - Street 2:FORT KENT
Practice Address - City:FORT KENT
Practice Address - State:ME
Practice Address - Zip Code:04743-1428
Practice Address - Country:US
Practice Address - Phone:207-834-3155
Practice Address - Fax:207-834-2949
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD26053207Q00000X
MEMD17450207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine