Provider Demographics
NPI:1659410314
Name:HARTWELL, BARBARA ANN (LAC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:HARTWELL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11517 23RD AVE S
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-1257
Mailing Address - Country:US
Mailing Address - Phone:952-894-5090
Mailing Address - Fax:
Practice Address - Street 1:13335 PALOMINO DRIVE
Practice Address - Street 2:SUITE 202
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124
Practice Address - Country:US
Practice Address - Phone:952-953-9499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1004171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist