Individual
JENNIFER ANN HARTL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
621 MEMORIAL DR STE 100, SOUTH BEND, IN 46601-1063
(574) 647-1100
(574) 647-3148
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-3725
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28196967A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201358530
—
IN
01
—
PENDING
RR MEDICARE
IN
05
—
PENDING
—
IN
Enumeration date
03/08/2016
Last updated
07/24/2026
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