Provider Demographics
NPI:1518648633
Name:HARTLEY, DANIEL JESSON (DNP, FNP-BC, APRN)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JESSON
Last Name:HARTLEY
Suffix:
Gender:M
Credentials:DNP, FNP-BC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 936857
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-6857
Mailing Address - Country:US
Mailing Address - Phone:910-662-6600
Mailing Address - Fax:910-332-0246
Practice Address - Street 1:1333 S DICKINSON DR STE 140ABC
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-6430
Practice Address - Country:US
Practice Address - Phone:910-662-6600
Practice Address - Fax:910-332-0246
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5018519363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily