Individual
MRS. KELLI KOVACH HARTMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, AGACNP-BC
Contact information
Practice address
6700 W IH 10, SAN ANTONIO, TX 78201-2009
(210) 736-6700
Mailing address
1132 LAKESIDE DR, LAKEHILLS, TX 78063-6477
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
AP135682
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
AP135682
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
380317301
—
TX
01
—
380317302
CSHNC
TX
Enumeration date
11/02/2017
Last updated
01/23/2019
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