Provider Demographics
NPI:1376547067
Name:HARTT, CATHY F (RN, CNM)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:F
Last Name:HARTT
Suffix:
Gender:F
Credentials:RN, CNM
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 39
Mailing Address - Street 2:
Mailing Address - City:NUCLA
Mailing Address - State:CO
Mailing Address - Zip Code:81424-0039
Mailing Address - Country:US
Mailing Address - Phone:970-864-3719
Mailing Address - Fax:970-864-2286
Practice Address - Street 1:851 MAIN STREET
Practice Address - Street 2:
Practice Address - City:NUCLA
Practice Address - State:CO
Practice Address - Zip Code:81424
Practice Address - Country:US
Practice Address - Phone:970-864-3719
Practice Address - Fax:970-864-2286
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO76690367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07766900Medicaid