Provider Demographics
NPI:1043876998
Name:DENAME, HALEIGH LYNN (FNP)
Entity Type:Individual
Prefix:
First Name:HALEIGH
Middle Name:LYNN
Last Name:DENAME
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 1:8 MAPLE ROW
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-1007
Mailing Address - Country:US
Mailing Address - Phone:914-364-1131
Mailing Address - Fax:
Practice Address - Street 1:8 MAPLE ROW
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-1007
Practice Address - Country:US
Practice Address - Phone:914-364-1131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF344196-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner