Provider Demographics
NPI:1912943077
Name:HARTLEY, RACHEL (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:
Last Name:HARTLEY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 UNION ST
Mailing Address - Street 2:MAINE COAT MEMORIAL HOSPITAL
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-1586
Mailing Address - Country:US
Mailing Address - Phone:207-664-5304
Mailing Address - Fax:207-664-5305
Practice Address - Street 1:50 UNION ST
Practice Address - Street 2:MAINE COAT MEMORIAL HOSPITAL
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1586
Practice Address - Country:US
Practice Address - Phone:207-664-5304
Practice Address - Fax:207-664-5305
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER030793363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME102380100Medicaid
ME24688099Medicaid
ME102380100Medicaid
S50622Medicare UPIN
MEHAN0952Medicare ID - Type UnspecifiedMEDICARE - PERS
MENP0952Medicare PIN
ME201300Medicare Oscar/Certification
ME20Z300Medicare PIN