Lolita Denise Hartley, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

902992 Issued in MS

Practice address

1828 Hospital Dr
Jackson, MS 39204-3410

Phone

(601) 487-8594

Fax

(601) 487-8570

NPI assigned

Mar 18, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1306305487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 CHERRY GROVE RD",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390598749",
            "telephone_number": "601-316-1474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 HOSPITAL DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043410",
            "telephone_number": "601-487-8594",
            "fax_number": "601-487-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLEY",
        "first_name": "LOLITA",
        "middle_name": "DENISE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "902992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lolita.hartley@va.gov",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1500 E Woodrow Wilson Ave",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392165116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Virginia Austin Harrison, M.D.
• Hayven David Hart, MPH
• Kyle Christopher Hart, MD
• Tonja Grines Hart, FNP
• Joshua Allen Hartley
• Durward Stanley Hartness, MD
• Jeffery Dale Hartsog, DMD
• Harvey Enterprises
• Adriane Wright Harvey, PMHNP-BC
• Angela Tamekia Harvey, LCMHT

• Psychiatric/Mental Health Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.