Provider Demographics
NPI:1972541316
Name:HARTSELL, DARE UNDERWOOD (RN)
Entity Type:Individual
Prefix:
First Name:DARE
Middle Name:UNDERWOOD
Last Name:HARTSELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 7TH CT S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35212-3922
Mailing Address - Country:US
Mailing Address - Phone:205-824-6250
Mailing Address - Fax:205-824-6251
Practice Address - Street 1:3100 LORNA RD
Practice Address - Street 2:SUITE 106
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-5453
Practice Address - Country:US
Practice Address - Phone:205-824-6250
Practice Address - Fax:205-824-6251
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-077878163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator