Provider Demographics
NPI:1336101187
Name:BAKELAAR, HALI JO (ANP-C)
Entity Type:Individual
Prefix:MRS
First Name:HALI
Middle Name:JO
Last Name:BAKELAAR
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:MS
Other - First Name:HALI
Other - Middle Name:JO
Other - Last Name:FROST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ANP-C
Mailing Address - Street 1:122 EAGLES NEST DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27712-2989
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:508 FULTON ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3875
Practice Address - Country:US
Practice Address - Phone:919-286-0411
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC169436363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health