1225455959 NPI number — MS. JANET M. HARTWIG LPN

Table of content: MS. JANET M. HARTWIG LPN (NPI 1225455959)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225455959 NPI number — MS. JANET M. HARTWIG LPN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARTWIG
Provider First Name:
JANET
Provider Middle Name:
M.
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LPN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUGHES
Provider Other First Name:
JANET
Provider Other Middle Name:
M.
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1225455959
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/19/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10841 SWAN CREEK ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARLETON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48117
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-497-8161
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
41308 CROSSBOW CIRCLE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CANTON
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48188
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-497-8161
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/19/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 164W00000X , with the licence number:  4703035850 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)