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General NPI Number Information
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NPI Number | 1891856654
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Entity Type | Individual
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Provider Name | DANIEL JOHN HARTLEY RN, MSN, NP
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Gender | Male
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 12/31/2008
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Provider Practice Location Address
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Address Line | 1200 B GALE WILSON BLVD MS 10-100
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City | FAIRFIELD
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State | CA
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Zip | 94533-3552
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Country | US
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Telephone | 707-864-5383
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Fax |
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Provider Business Mailing Address
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Address Line | 136 CHAFFEY CT
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City | VACAVILLE
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State | CA
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Zip | 95687-4619
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Country | US
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Telephone | 707-451-4123
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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 | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | RN523252
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP 15794
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License Number State | CA
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