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BIRTHA V HARTNESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
195 HOSPITAL DRIVE, SUITE A, CHEROKEE VILLAGE, AR 72529
(870) 257-6060
(870) 257-7664
Mailing address
195 HOSPITAL DRIVE, SUITE A, CHEROKEE VILLAGE, AR 72529
(870) 257-6060
(870) 257-7664

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AO1567
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
152967758
AR
01
5U647
BLUE CROSS BLUE SHEILD
AR
01
770016758
BREAST CARE PROVIDER #
AR
01
AO 1567
STATE LICENSE NUMBER
AR
01
P00134956
MEDICARE RAILROAD
AR
Enumeration date
01/12/2006
Last updated
03/07/2023
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