Active NPI
Nancy Devereaux Hartl
- Obstetrics & Gynecology Nurse Practitioner
- Sacramento, CA
National Provider Identifier
1760501209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Nurse Practitioner
- License
- 520077
- Practice address
- 1650 Response Rd
Sacramento, CA 95815-4807 - Phone
- (916) 614-4055
- NPI assigned
- Mar 28, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | 520077 | CA | Primary |
Addresses
Primary practice location
1650 Response Rd
Sacramento, CA 95815-4807
Mailing address
1600 Eureka Rd BLDG C3
Roseville, CA 95661-3027
Phone (916) 474-2429
Other names 1
- Ms. Nancy Devereaux-Hartl Stanziano
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8224 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308700800000",
"number": "1760501209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 EUREKA RD BLDG C3",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956613027",
"telephone_number": "916-474-2429",
"fax_number": "916-474-2411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 RESPONSE RD",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958154807",
"telephone_number": "916-614-4055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTL",
"first_name": "NANCY",
"middle_name": "DEVEREAUX",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-28",
"last_updated": "2011-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LX0001X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": "CA",
"license": "520077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NANCY",
"last_name": "STANZIANO",
"middle_name": "DEVEREAUX-HARTL",
"prefix": "MS.",
"credential": "N.P.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.