Provider Demographics
NPI:1740730233
Name:HARTMAN, BRITTANY ANN
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:ANN
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 E 16TH ST
Mailing Address - Street 2:APT 4
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-9102
Mailing Address - Country:US
Mailing Address - Phone:904-400-8320
Mailing Address - Fax:
Practice Address - Street 1:815 E 16TH ST
Practice Address - Street 2:APT 4
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-9102
Practice Address - Country:US
Practice Address - Phone:904-400-8320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHW186191045OtherAETNA