Provider Demographics
NPI:1831471689
Name:HARTNEY, TRUDY DIETRA
Entity Type:Individual
Prefix:
First Name:TRUDY
Middle Name:DIETRA
Last Name:HARTNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 W SOUTH ST APT 40
Mailing Address - Street 2:
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-3157
Mailing Address - Country:US
Mailing Address - Phone:979-549-4379
Mailing Address - Fax:
Practice Address - Street 1:1601 W SOUTH ST APT 40
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-3157
Practice Address - Country:US
Practice Address - Phone:979-549-4379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide