Diane L Hartzog, CRNA - Anesthesiologist Assistant in Watertown, WI

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Diane L Hartzog, CRNA is a Anesthesiologist Assistant based in Watertown, Wisconsin. Diane L Hartzog is licensed to practice in Wisconsin (license number 78920030) and her current practice location is 125 Hospital Drive, Watertown, Wisconsin. She can be reached at her office (for appointments etc.) via phone at (920) 262-4450.

NPI number for Diane L Hartzog is 1871538744 and her current mailing address is 4555 West Schroeder Drive, Suite 170, Milwaukee, Wisconsin. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1871538744.

Contact Information

Diane L Hartzog, CRNA
125 Hospital Drive,
Watertown, WI 53098
(920) 262-4450
Not Available

Map and Direction




Provider's Profile

Full NameDiane L Hartzog
GenderFemale
SpecialityAnesthesiologist Assistant
Location125 Hospital Drive, Watertown, Wisconsin
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1871538744
  • Provider Enumeration Date: 06/17/2006
  • Last Update Date: 03/27/2008

Medical Identifiers

Medical identifiers for Diane L Hartzog such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1871538744NPI-NPPES
43379900MedicaidWI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367H00000XAnesthesiologist Assistant 78920030 (Wisconsin)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Diane L Hartzog is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Diane L Hartzog, CRNA
4555 West Schroeder Drive, Suite 170,
Milwaukee, WI 53223

Ph: (414) 365-3210		Diane L Hartzog, CRNA
125 Hospital Drive,
Watertown, WI 53098

Ph: (920) 262-4450

Reviews and Comments


Anesthesiologist Assistant Nurses in Watertown, WI


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