Provider Demographics
NPI:1033737960
Name:ADKINS, HALEY CANTRELL (FNP-BC)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:CANTRELL
Last Name:ADKINS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1087 CARRIAGE HILLS PL
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2360
Mailing Address - Country:US
Mailing Address - Phone:276-220-3661
Mailing Address - Fax:
Practice Address - Street 1:3114 BROWNS MILL RD
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-1417
Practice Address - Country:US
Practice Address - Phone:423-631-0432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024179642363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ064284Medicaid
VA1033737960Medicaid