Provider Demographics
NPI:1295816809
Name:HARTZELL, CATHERINE (CNP)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:HARTZELL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:CATHERINE (KATE)
Other - Middle Name:WERTZ
Other - Last Name:HARTZELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNP
Mailing Address - Street 1:705 LAGUNITA DR
Mailing Address - Street 2:
Mailing Address - City:SOQUEL
Mailing Address - State:CA
Mailing Address - Zip Code:95073-9598
Mailing Address - Country:US
Mailing Address - Phone:831-479-6435
Mailing Address - Fax:831-477-5634
Practice Address - Street 1:705 LAGUNITA DR
Practice Address - Street 2:
Practice Address - City:SOQUEL
Practice Address - State:CA
Practice Address - Zip Code:95073-9598
Practice Address - Country:US
Practice Address - Phone:831-479-6435
Practice Address - Fax:831-477-5634
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA351512 9076363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily