Individual
SALLY J HARTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2700 S LAFAYETTE ST, SUITE 200, FORT WAYNE, IN 46806-1100
(260) 744-3000
(260) 744-3006
Mailing address
2700 LAFAYETTE ST, SUITE 200, FORT WAYNE, IN 46806-1100
(260) 744-3000
(260) 744-3006
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
28058145A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100098040A
—
IN
Enumeration date
09/30/2008
Last updated
09/30/2008
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