Individual
TAMARA ANNE HARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
10628 PARK RD, CHARLOTTE, NC 28210-8407
(704) 667-1000
(704) 667-0409
Mailing address
4400 GOLF ACRES DR, CHARLOTTE, NC 28208-5968
(704) 512-6428
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704237430
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8054027
—
NC
05
—
AN1546
—
SC
Enumeration date
09/20/2006
Last updated
04/26/2017
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