Basic Information
| Provider Information | |||||||||
| NPI: | 1093215709 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HATLEY | ||||||||
| FirstName: | JANET | ||||||||
| MiddleName: | FLOYD | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | X | ||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 227 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273713058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9105723681 | ||||||||
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| Practice Location | |||||||||
| Address1: | 227 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273713058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9105723681 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/19/2018 | ||||||||
| LastUpdateDate: | 02/19/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SP0809X | 279690 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psych/Mental Health, Adult |
No ID Information.