Provider Demographics
NPI:1053980938
Name:WEBB, HALEY (FNP)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 OAKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ERWIN
Mailing Address - State:TN
Mailing Address - Zip Code:37650-8945
Mailing Address - Country:US
Mailing Address - Phone:423-747-6788
Mailing Address - Fax:
Practice Address - Street 1:134 OAKWOOD LN
Practice Address - Street 2:
Practice Address - City:ERWIN
Practice Address - State:TN
Practice Address - Zip Code:37650-8945
Practice Address - Country:US
Practice Address - Phone:423-747-6788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29729207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine