Individual
KIM L HARTMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5618 ODANA RD, MADISON, WI 53719-1208
(608) 828-7611
(608) 260-6939
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
773
WI
363AM0700X
Medical Physician Assistant
Primary
773-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306894068
—
WI
Enumeration date
05/05/2006
Last updated
11/16/2021
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