DR. Nicole Ann Hartsough, M.D.

NPI #1962400382 in Loves Park, Illinois

Provider Information

NPI Number: 1962400382
Entity Type: Individual
Name: DR. Nicole Ann Hartsough, M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dermatology
Credential: M.D.
Enumeration Date: Jul 10, 2005
Last Updated: Oct 18, 2007

Practice Location

Address: 7402 E RIVERSIDE BLVD
City: Loves Park
State: Illinois
ZIP Code: 61111-5630
Phone: (815) 226-9642

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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