Provider Demographics
NPI:1932721768
Name:BARTLEY, RICHELLE (RN)
Entity Type:Individual
Prefix:
First Name:RICHELLE
Middle Name:
Last Name:BARTLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:RICHELLE
Other - Middle Name:
Other - Last Name:BARTLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8894 PIPESTONE WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2182
Mailing Address - Country:US
Mailing Address - Phone:619-997-8031
Mailing Address - Fax:
Practice Address - Street 1:8894 PIPESTONE WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-2182
Practice Address - Country:US
Practice Address - Phone:619-997-8031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95218147163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse