Provider Demographics
NPI:1467694414
Name:HARTMAN, GENA MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:GENA
Middle Name:MARIE
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:GENA
Other - Middle Name:MARIE
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-265-8932
Mailing Address - Fax:352-265-8952
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610
Practice Address - Country:US
Practice Address - Phone:352-265-8932
Practice Address - Fax:352-265-8952
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9168974363L00000X
FLARNP9168974363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001005200Medicaid
FL001005200Medicaid
FLBT083XMedicare PIN