Healthcare Provider Details

I. General information

NPI: 1093215709
Provider Name (Legal Business Name): JANET FLOYD HATLEY X RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2018
Last Update Date: 02/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 N MAIN ST
TROY NC
27371-3058
US

IV. Provider business mailing address

227 N MAIN ST
TROY NC
27371-3058
US

V. Phone/Fax

Practice location:
  • Phone: 910-572-3681
  • Fax:
Mailing address:
  • Phone: 910-572-3681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number279690
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: