Provider Demographics
NPI:1619549045
Name:HARTWELL, AUDREY MORGAN (CF-SLP)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:MORGAN
Last Name:HARTWELL
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:MORGAN
Other - Last Name:NITZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2320 N COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-2286
Mailing Address - Country:US
Mailing Address - Phone:402-721-7710
Mailing Address - Fax:
Practice Address - Street 1:2320 N COLORADO AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2286
Practice Address - Country:US
Practice Address - Phone:269-823-8753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist