Provider Demographics
NPI:1558026914
Name:COLWELL, HALEY
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:COLWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 COUNTY ROAD 148
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:AL
Mailing Address - Zip Code:35540-3652
Mailing Address - Country:US
Mailing Address - Phone:256-727-0778
Mailing Address - Fax:
Practice Address - Street 1:899 COUNTY ROAD 148
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:AL
Practice Address - Zip Code:35540-3652
Practice Address - Country:US
Practice Address - Phone:256-727-0778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program