Healthcare Provider Details

I. General information

NPI: 1275803876
Provider Name (Legal Business Name): ARTHUR BAXTER HANLEY JR. R.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2012
Last Update Date: 01/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HAMPTON VA MEDICAL CTR 100 EMANCIPATION DR
HAMPTON VA
23667-0001
US

IV. Provider business mailing address

HAMPTON VA MEDICAL CTR 100 EMANCIPATION DR
HAMPTON VA
23667-0001
US

V. Phone/Fax

Practice location:
  • Phone: 757-722-9961
  • Fax: 757-728-7281
Mailing address:
  • Phone: 757-722-9961
  • Fax: 757-728-7281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN 0001174185
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: