Provider Demographics
NPI:1699863001
Name:HARTLEY, KAREN MOSS (DPH)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MOSS
Last Name:HARTLEY
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 RISING SUN LN
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-2100
Mailing Address - Country:US
Mailing Address - Phone:615-847-4062
Mailing Address - Fax:615-262-6118
Practice Address - Street 1:710 HART LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37247-0801
Practice Address - Country:US
Practice Address - Phone:615-650-7000
Practice Address - Fax:615-262-6118
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2435183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist