Provider Demographics
NPI:1285341446
Name:HARTLEY, ERNIE S (MSN FNP-BC)
Entity type:Individual
Prefix:MS
First Name:ERNIE
Middle Name:S
Last Name:HARTLEY
Suffix:
Gender:F
Credentials:MSN FNP-BC
Other - Prefix:MS
Other - First Name:NITYA
Other - Middle Name:
Other - Last Name:HARTLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2312 W 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-4915
Mailing Address - Country:US
Mailing Address - Phone:903-493-6181
Mailing Address - Fax:
Practice Address - Street 1:2312 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-4915
Practice Address - Country:US
Practice Address - Phone:903-915-1161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-27
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX969405163W00000X
TX1099340363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse