Provider Demographics
NPI:1932668456
Name:HARTMAN, AMY ANNETTE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ANNETTE
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1289 DEER HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-1297
Mailing Address - Country:US
Mailing Address - Phone:804-551-6811
Mailing Address - Fax:434-215-3993
Practice Address - Street 1:1310 CHURCH ST
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24504-4604
Practice Address - Country:US
Practice Address - Phone:434-847-5050
Practice Address - Fax:434-215-3993
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176805363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner