Basic Information
| Provider Information | |||||||||
| NPI: | 1407175532 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARTMAN | ||||||||
| FirstName: | M | ||||||||
| MiddleName: | EVELYN | ||||||||
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| Credential: | MSN, NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 PELHAM RD | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296153300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8642345800 | ||||||||
| FaxNumber: | 8642345881 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 PELHAM RD | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296153300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8642345800 | ||||||||
| FaxNumber: | 8642345888 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2010 | ||||||||
| LastUpdateDate: | 03/29/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 14646 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 14646 | 01 | CA BOARD OF NURSING | OTHER |