Hartman, Ellyn W.

Hartman, Ellyn W. is an individual health care provider with primary practice located at 5525 Grossmont Center Dr , La Mesa CA 91942-3009. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Hartman, Ellyn W. can be contacted via phone (619) 644-6905.

Contact Information

Primary practice address
5525 Grossmont Center Dr La Mesa CA 91942-3009
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X RN225948 California

Profile Details

NPI number 1245240738
LBN Legal business name Hartman, Ellyn W.
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 8th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245240738 NPPES
California MEDICAID RN225948

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