Provider Demographics
NPI:1457911125
Name:HATLEY, LYNDA ANNE (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:ANNE
Last Name:HATLEY
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 HUMMINGBIRD TRL
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-2822
Mailing Address - Country:US
Mailing Address - Phone:817-733-5557
Mailing Address - Fax:
Practice Address - Street 1:9557 N BEACH ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6437
Practice Address - Country:US
Practice Address - Phone:817-741-5050
Practice Address - Fax:817-741-5059
Is Sole Proprietor?:No
Enumeration Date:2019-06-16
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141819363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily