Provider Demographics
NPI:1164912721
Name:HARTMAN, SHAYLA KAY (APN)
Entity type:Individual
Prefix:
First Name:SHAYLA
Middle Name:KAY
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 681
Mailing Address - Street 2:
Mailing Address - City:WALDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80480-0681
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:705 2ND STREET
Practice Address - Street 2:
Practice Address - City:HART
Practice Address - State:TX
Practice Address - Zip Code:79043
Practice Address - Country:US
Practice Address - Phone:806-938-2299
Practice Address - Fax:806-937-0015
Is Sole Proprietor?:No
Enumeration Date:2018-05-18
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0993514-NP363LF0000X
TXAP131959363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily