Provider Demographics
NPI:1770743262
Name:HARTNETT, CRAIG PARTRICK
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:PARTRICK
Last Name:HARTNETT
Suffix:
Gender:M
Credentials:
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 127
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NE
Mailing Address - Zip Code:68743-0127
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 VINE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NE
Practice Address - Zip Code:68743
Practice Address - Country:US
Practice Address - Phone:303-941-8210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12505225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist