Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | APN001011 | NV |
NPI | 1043498124 |
---|---|
Provider Name | Janice Marie Haley |
First Address | Henderson, NV 89015-6028 |
Second Address | Henderson, NV 89015-6028 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2008 |
Last Update Date | 31/01/2008 |