Provider Demographics
NPI:1114423936
Name:HALEY, LAUREN LEIGH (FNP-BC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:LEIGH
Last Name:HALEY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:LEIGH
Other - Last Name:BOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:110 23RD ST NW
Mailing Address - Street 2:
Mailing Address - City:FAYETTE
Mailing Address - State:AL
Mailing Address - Zip Code:35555-1001
Mailing Address - Country:US
Mailing Address - Phone:205-932-3891
Mailing Address - Fax:205-487-8827
Practice Address - Street 1:110 23RD ST NW
Practice Address - Street 2:
Practice Address - City:FAYETTE
Practice Address - State:AL
Practice Address - Zip Code:35555-1001
Practice Address - Country:US
Practice Address - Phone:205-932-3891
Practice Address - Fax:205-487-8827
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-140252363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily