Hartley, Charlene Theresa
Hartley, Charlene Theresa is an individual health care provider with primary practice located at 425 Daytona Ave , Holly Hill FL 32117-3721. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Hartley, Charlene Theresa can be contacted via phone (386) 258-8291.Contact Information
Primary practice address
425 Daytona Ave
Holly Hill FL 32117-3721
Phone: (386) 258-8291
Fax: (386) 258-8291
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Community Health Worker | 172V00000X | ALF10338 | Florida |
Profile Details
| NPI number | 1649695974 |
|---|---|
| LBN Legal business name | Hartley, Charlene Theresa |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 24th, 2014 |
| Last updated | Feb 24th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649695974 | NPPES |
| Florida | MEDICAID | 142002000 |
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