Individual
MRS. TASHINA ROBERTS HARTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-3069
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-3069
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
188643
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078275
CRNA CERTIFICATE NUMBER
NC
Enumeration date
09/18/2007
Last updated
10/01/2007
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