Individual
REBECCA LAUREN HARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3630 SUNSET BLVD, WEST COLUMBIA, SC 29169-3052
(803) 999-1448
Mailing address
3630 SUNSET BLVD, WEST COLUMBIA, SC 29169-3052
(803) 999-1448
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
29592
SC
363LF0000X
Family Nurse Practitioner
Primary
29592
SC
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
02/19/2024
Last updated
07/03/2025
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