Provider Demographics
NPI:1235227810
Name:HARTLEY, KRISTIN LORRAINE (APRN,FNP-C, MSN,BSN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:LORRAINE
Last Name:HARTLEY
Suffix:
Gender:F
Credentials:APRN,FNP-C, MSN,BSN
Other - Prefix:MISS
Other - First Name:KRISTIN
Other - Middle Name:LORRAINE
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, FNP C,MSN,BSN
Mailing Address - Street 1:2236 RIVERMONT PL
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-5810
Mailing Address - Country:US
Mailing Address - Phone:843-766-3719
Mailing Address - Fax:
Practice Address - Street 1:181 CALHOUN STREET
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29424
Practice Address - Country:US
Practice Address - Phone:843-953-6375
Practice Address - Fax:843-953-6377
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPRN 2974363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily