Healthcare Provider Details

I. General information

NPI: 1043649817
Provider Name (Legal Business Name): SATOYA LOREEN HARTFIELD NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SATOYA LOREEN JACKSON NP

II. Dates (important events)

Enumeration Date: 11/02/2013
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 TURNER MCCALL BLVD SW STE 107
ROME GA
30165-5631
US

IV. Provider business mailing address

420 E 2ND AVE SUITE 103
ROME GA
30161-3209
US

V. Phone/Fax

Practice location:
  • Phone: 706-509-6439
  • Fax:
Mailing address:
  • Phone: 706-509-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN234345
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: