Provider Demographics
NPI:1932451572
Name:MILLER-HARTMANN, MARTEEN ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MARTEEN
Middle Name:ELIZABETH
Last Name:MILLER-HARTMANN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:MARTEEN
Other - Middle Name:ELIZABETH
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RRT
Mailing Address - Street 1:11261 BUFFALO DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-2227
Mailing Address - Country:US
Mailing Address - Phone:951-710-0091
Mailing Address - Fax:
Practice Address - Street 1:11261 BUFFALO DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-2227
Practice Address - Country:US
Practice Address - Phone:951-710-0091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-05
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA22552363A00000X
CA28293227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered