Provider Demographics
NPI:1326270505
Name:HARTSFIELD, JENNIFER LYNN (FNP-BC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:HARTSFIELD
Suffix:
Gender:
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 1:111 SW NAITO PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-3512
Mailing Address - Country:US
Mailing Address - Phone:888-288-4715
Mailing Address - Fax:833-260-2594
Practice Address - Street 1:106 LANGTREE VILLAGE DR STE 301
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-7594
Practice Address - Country:US
Practice Address - Phone:888-288-4715
Practice Address - Fax:833-260-2594
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9227314363L00000X
AZAP8517363LF0000X
OHAPRN.CNP.0037419363LF0000X
NC5020888363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner