Provider Demographics
NPI:1548280647
Name:HARTMAN, SHARON (NP)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:SCHROCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1130 MEDICAL ARTS BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-3431
Practice Address - Country:US
Practice Address - Phone:765-298-4282
Practice Address - Fax:765-298-4989
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000429A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000711431OtherANTHEM
IN200945420Medicaid
IN213410FMedicare PIN
IN000000711431OtherANTHEM
IN200945420Medicaid