Provider Demographics
NPI:1053713685
Name:HALEY, WHITNEY PAIGE (AGACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:PAIGE
Last Name:HALEY
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:PAIGE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGACNP-BC
Mailing Address - Street 1:4230 HARDING PIKE STE 503
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2098
Mailing Address - Country:US
Mailing Address - Phone:615-964-5864
Mailing Address - Fax:615-269-7359
Practice Address - Street 1:4230 HARDING PIKE STE 503
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2098
Practice Address - Country:US
Practice Address - Phone:159-645-8646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-26
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19202363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ008841Medicaid
KY7100423640Medicaid
KY7100423640Medicaid