Provider Demographics
NPI:1871908905
Name:HARTSHORN, MICHELLE LAVERNE (ACNP)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LAVERNE
Last Name:HARTSHORN
Suffix:
Gender:F
Credentials:ACNP
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Mailing Address - Street 1:4301 W MARKHAM ST # 783
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-686-8000
Mailing Address - Fax:501-526-5148
Practice Address - Street 1:707 W VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-2119
Practice Address - Country:US
Practice Address - Phone:661-822-2530
Practice Address - Fax:661-822-2536
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2024-04-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AR219418363LA2100X
CANP95000823363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care