Individual
DIANE L HARTZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
125 HOSPITAL DRIVE, WATERTOWN, WI 53098
(920) 262-4450
Mailing address
4555 WEST SCHROEDER DRIVE, SUITE 170, MILWAUKEE, WI 53223
(414) 365-3210
(414) 365-3225
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
78920030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43379900
—
WI
Enumeration date
06/17/2006
Last updated
03/27/2008
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