Individual
DANIEL HARTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
303 HARRIS INDUSTRIAL BLVD STE 5, VIDALIA, GA 30474-8854
(912) 535-7000
Mailing address
9768 SAINT MATHEWS CHURCH RD, METTER, GA 30439-7738
(912) 682-9600
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN216852
GA
363LF0000X
Family Nurse Practitioner
RN216852
GA
Other
Enumeration date
11/03/2016
Last updated
05/21/2021
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