Individual
NICOLE L HARTVIGSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
407 N. WASHINGTON STREET, STE. 100, FALLS CHURCH, VA 22046
(703) 237-5919
(703) 241-1863
Mailing address
407 N. WASHINGTON STREET, STE. 100, FALLS CHURCH, VA 22046
(703) 237-5919
(703) 241-1863
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
04-31628
KS
208000000X
Pediatrics Physician
Primary
2005007054
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200332820A
—
KS
05
—
207198904
—
MO
Enumeration date
04/25/2006
Last updated
01/18/2012
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