Individual
JENNIFER ANN HARTL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
303 S NAPPANEE ST, ELKHART, IN 46514-2066
(574) 296-3200
(574) 296-3392
Mailing address
PO BOX 2968, ELKHART, IN 46515-2968
(574) 296-3200
(574) 296-3392
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28196967A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
RR MEDICARE
IN
05
—
PENDING
—
IN
Enumeration date
03/08/2016
Last updated
03/08/2016
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