Provider Demographics
NPI:1336712611
Name:HARTMAN, GINGER R (RD)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:R
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9633 E 5TH AVE APT 2101
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7212
Mailing Address - Country:US
Mailing Address - Phone:928-231-0545
Mailing Address - Fax:
Practice Address - Street 1:9633 E 5TH AVE APT 2101
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7212
Practice Address - Country:US
Practice Address - Phone:928-231-0545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO870360133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered