Provider Demographics
NPI:1407743834
Name:HARTMAN, LACEY LYNNE (CRNP)
Entity type:Individual
Prefix:
First Name:LACEY
Middle Name:LYNNE
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LACEY
Other - Middle Name:LYNNE
Other - Last Name:HARTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LACEY RITTENHOUSE
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:717-242-7145
Mailing Address - Fax:717-242-7729
Practice Address - Street 1:400 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-1167
Practice Address - Country:US
Practice Address - Phone:717-242-7145
Practice Address - Fax:717-242-7729
Is Sole Proprietor?:No
Enumeration Date:2025-06-19
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP033136363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner