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General NPI Number Information
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NPI Number | 1730683483
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Entity Type | Individual
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Provider Name | ANGELA HARTLEY CPM, LDM
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Gender | Female
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Dates
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Enumeration Date | 03/19/2018
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Last Update Date | 03/19/2018
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Provider Practice Location Address
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Address Line | 3600 CEDAR FLAT RD
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City | WILLIAMS
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State | OR
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Zip | 97544-9682
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Country | US
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Telephone | 541-846-1227
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 211
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City | WILLIAMS
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State | OR
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Zip | 97544-0211
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Country | US
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Telephone | 831-566-0877
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | DEM-LD-10189771
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License Number State | OR
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