Kim Rae Hartnett, RN
Individual provider Active NPI Registered Nurse · Belmont, WI
NPI 1104015965 · NPPES record last updated Oct 17, 2007
Key facts
- NPI
- 1104015965
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- Practice address
- 205 East State Street
Belmont, WI 53510 - Phone
- (608) 762-5985
- NPI assigned
- Oct 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 159860030 | WI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | WI | Yes |
Addresses
Primary practice location
205 East State Street
Belmont, WI 53510
Mailing address
205 East State Street
Belmont, WI 53510
Phone (608) 762-5985
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35034100 | Medicaid | WI |
Other providers in Belmont, WI
- Belmont Community School District
- Belmont Fire Protection District, Inc.
- Lynette Gates
- Michelle Marie Monson
- Cheyenne Nodorft
All providers in Belmont, WI · Registered Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.