Provider Demographics
NPI:1861476582
Name:HARTIG, DEBRA JEAN (RN, NP)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:JEAN
Last Name:HARTIG
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 324
Mailing Address - Street 2:15828 CLODHOPPER DR
Mailing Address - City:SHASTA
Mailing Address - State:CA
Mailing Address - Zip Code:96087-0324
Mailing Address - Country:US
Mailing Address - Phone:530-246-7126
Mailing Address - Fax:
Practice Address - Street 1:2787 EUREKA WAY
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0224
Practice Address - Country:US
Practice Address - Phone:530-243-1552
Practice Address - Fax:530-243-0916
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN227667163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2946OtherNPF
MH0601321OtherDEA
P21427Medicare UPIN