Provider Demographics
NPI:1124575253
Name:WEEKS, HAILEY (PA-C)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:
Last Name:WEEKS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 PRESCOTT RD STE 201
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3983
Mailing Address - Country:US
Mailing Address - Phone:318-442-6767
Mailing Address - Fax:318-441-1359
Practice Address - Street 1:3311 PRESCOTT RD
Practice Address - Street 2:SUITE201
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3900
Practice Address - Country:US
Practice Address - Phone:318-442-6767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA303578363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2433733Medicaid