Provider Demographics
NPI:1184091282
Name:HARTNETT, PAMELA DAWN (DNP)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:DAWN
Last Name:HARTNETT
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2608 S 158TH PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-1704
Mailing Address - Country:US
Mailing Address - Phone:402-578-5353
Mailing Address - Fax:402-715-5040
Practice Address - Street 1:2608 S 158TH PLZ
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-1704
Practice Address - Country:US
Practice Address - Phone:402-578-5353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-25
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111850363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily