Provider Demographics
NPI:1811903404
Name:HARTLEY, GAIL (RNP)
Entity type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:
Last Name:HARTLEY
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 N 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-7401
Mailing Address - Country:US
Mailing Address - Phone:626-566-2866
Mailing Address - Fax:800-924-7301
Practice Address - Street 1:1015 N 1ST AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-7401
Practice Address - Country:US
Practice Address - Phone:626-566-2866
Practice Address - Fax:800-924-7301
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF10139363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP10139OtherSTATE LICENCE
CANP10139OtherSTATE LICENCE