Hartley, Mary Beth

Hartley, Mary Beth is an individual health care provider with primary practice located at 1400 W 4Th St , Coffeyville KS 67337-3306. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Hartley, Mary Beth can be contacted via phone (620) 688-6566.

Contact Information

Primary practice address
1400 W 4Th St Coffeyville KS 67337-3306
Phone: (620) 688-6566
Fax: (620) 688-6577
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 45384 Kansas
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 121186 Missouri

Profile Details

NPI number 1073510764
LBN Legal business name Hartley, Mary Beth
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Nov 30th, 2016 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073510764 NPPES
Kansas MEDICAID 100446860G
Kansas Other 110385030
Kansas MEDICAID 100446860D

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