Provider Demographics
NPI:1588837991
Name:HARTUNG, THERESA MARGARET (RN)
Entity type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:MARGARET
Last Name:HARTUNG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N7052 SUNRISE LN
Mailing Address - Street 2:
Mailing Address - City:HOLMEN
Mailing Address - State:WI
Mailing Address - Zip Code:54636-9417
Mailing Address - Country:US
Mailing Address - Phone:608-769-8772
Mailing Address - Fax:
Practice Address - Street 1:N7052 SUNRISE LN
Practice Address - Street 2:
Practice Address - City:HOLMEN
Practice Address - State:WI
Practice Address - Zip Code:54636-9417
Practice Address - Country:US
Practice Address - Phone:608-769-8772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI94566-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse