Healthcare Provider Details

I. General information

NPI: 1417838624
Provider Name (Legal Business Name): WHITNEY RENEE HARTLEY LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2025
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1914 MERCER AVE
FARRELL PA
16121-2505
US

IV. Provider business mailing address

1126 WALNUT ST
FARRELL PA
16121-1228
US

V. Phone/Fax

Practice location:
  • Phone: 724-308-5934
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN297009
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: