Provider Demographics
NPI:1710316427
Name:HARTMAN, HESTER E (P A)
Entity Type:Individual
Prefix:
First Name:HESTER
Middle Name:E
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:P A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 BELFORT RD
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-5876
Mailing Address - Country:US
Mailing Address - Phone:904-296-3103
Mailing Address - Fax:904-296-3106
Practice Address - Street 1:4205 BELFORT RD
Practice Address - Street 2:SUITE 1100
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-5876
Practice Address - Country:US
Practice Address - Phone:904-296-3103
Practice Address - Fax:904-296-3106
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-03
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical