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Joshua Allen Hartley

Student in an Organized Health Care Education/Training Program in Jackson, MS. Individual provider (NPI-1).

NPI number1619703774
StatusActive
Last updated in NPPESSep 13, 2024

Details

NPI
1619703774
Entity type
Individual (NPI-1)
Name
Joshua Allen Hartley
Sex
Male
Sole proprietor
No
Enumeration date
Sep 13, 2024
Certification date
Sep 13, 2024
Last updated
Sep 13, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

2500 N State St
Jackson, MS 39216-4500

Phone 601-984-5012

Mailing address

2500 N State St
Jackson, MS 39216-4500

Phone 601-984-5012

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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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