MEDICARE: RACHAEL LAUREN HARTLEY NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	71008910A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063977825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHAEL LAUREN HARTLEY NP-C

Provider Business Mailing Address
First Line	:	842 WESTGATE DR
Second Line	:
City	:	ANDERSON
State	:	IN
Zip	:	46012-9678
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 SENATE BLVD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-1239
Country	:	US
Telephone Number	:	317-962-8776
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2019
Last Update Date	:	02/09/2026

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