Provider Demographics
NPI:1871604702
Name:HARTMAN, ELIZABETH H (ANP)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:H
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 MEDICAL VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855-9835
Mailing Address - Country:US
Mailing Address - Phone:802-334-3504
Mailing Address - Fax:802-334-3512
Practice Address - Street 1:41 MEDICAL VILLAGE DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-9835
Practice Address - Country:US
Practice Address - Phone:802-334-3504
Practice Address - Fax:802-334-3512
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1010009657363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT500004079OtherRAILROAD MEDICARE
VT8000222OtherLADIES FIRST
VT356627OtherMVP
VT00028667OtherBLUE SHIELD
VT0NP0618Medicaid
VT500004079OtherRAILROAD MEDICARE
VT00028667OtherBLUE SHIELD
VT8000222OtherLADIES FIRST