Provider Demographics
NPI:1588670095
Name:HARTJES, TONJA M (ARNP)
Entity Type:Individual
Prefix:MS
First Name:TONJA
Middle Name:M
Last Name:HARTJES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:TONJA
Other - Middle Name:MICHELLE
Other - Last Name:HARTJES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
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:
Mailing Address - Fax:
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-265-0486
Practice Address - Fax:352-338-9812
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1741932363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306262700Medicaid
FLDY113ZMedicare PIN