Provider Demographics
NPI:1629773049
Name:HARTONG, RACHEL (APRN)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:HARTONG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4835 EARLSCOURT CIR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-1594
Mailing Address - Country:US
Mailing Address - Phone:330-936-6181
Mailing Address - Fax:
Practice Address - Street 1:324 E MILLTOWN RD # C
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-2269
Practice Address - Country:US
Practice Address - Phone:330-345-1540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0033459363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily