Individual
JANET HARTGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, CPNP
Contact information
Practice address
22373 ICE TRL, SOUTH BEND, IN 46614-4422
(574) 335-6242
Mailing address
22373 ICE TRL, SOUTH BEND, IN 46614-4422
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
71003393A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201024060
—
IN
Enumeration date
10/04/2010
Last updated
06/20/2022
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