Provider Demographics
NPI:1174396741
Name:HARTUNG, ISABELLA MARIE
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:MARIE
Last Name:HARTUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5729 CORNICK RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-2201
Mailing Address - Country:US
Mailing Address - Phone:740-632-5804
Mailing Address - Fax:
Practice Address - Street 1:880 KEMPSVILLE RD STE 205
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3931
Practice Address - Country:US
Practice Address - Phone:757-451-0929
Practice Address - Fax:757-423-4901
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024189652367A00000X
VA0001276524163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient