Provider Demographics
NPI:1245903897
Name:HARTLEY, CHRISTINA M (CNP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:HARTLEY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
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Mailing Address - Street 1:211 EDGEFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-5801
Mailing Address - Country:US
Mailing Address - Phone:740-914-4178
Mailing Address - Fax:740-386-2640
Practice Address - Street 1:12906 STATE ROUTE 664 S STE A6
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:OH
Practice Address - Zip Code:43138-9262
Practice Address - Country:US
Practice Address - Phone:740-216-5028
Practice Address - Fax:740-216-5031
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0029114363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty