# MARY BETH HARTLEY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1073510764
- **Gender:** F
- **Credential:** APRN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 45384 | KS | Yes |
| 363LF0000X | Family Nurse Practitioner | 121186 | MO | — |

## Other

- **Enumeration date:** 07/07/2005
- **Last updated:** 11/30/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100446860D | — | KS |
| 05 | — | 100446860G | — | KS |
| 01 | — | 110385030 | MEDICARE PTAN | KS |