Provider Demographics
NPI:1831731629
Name:HARTL, JENNA STOVER (PA-C)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:STOVER
Last Name:HARTL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:420 LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3310
Mailing Address - Country:US
Mailing Address - Phone:717-519-7786
Mailing Address - Fax:
Practice Address - Street 1:1430 HARRISBURG PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2615
Practice Address - Country:US
Practice Address - Phone:717-327-4680
Practice Address - Fax:717-606-1116
Is Sole Proprietor?:No
Enumeration Date:2019-10-13
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program