Provider Demographics
NPI:1427442201
Name:HARTLEY, DONNA MARIE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE
Last Name:HARTLEY
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9159 FRANKTOWN RD
Mailing Address - Street 2:
Mailing Address - City:FRANKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23354
Mailing Address - Country:US
Mailing Address - Phone:757-442-4819
Mailing Address - Fax:757-442-9505
Practice Address - Street 1:9159 FRANKTOWN RD
Practice Address - Street 2:
Practice Address - City:FRANKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23354
Practice Address - Country:US
Practice Address - Phone:757-442-4819
Practice Address - Fax:757-442-9505
Is Sole Proprietor?:No
Enumeration Date:2015-03-19
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001140713163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics