Provider Demographics
NPI:1578988168
Name:HARRELSON, HALEY DAWN (MSN, RN, FNP-C)
Entity Type:Individual
Prefix:MISS
First Name:HALEY
Middle Name:DAWN
Last Name:HARRELSON
Suffix:
Gender:F
Credentials:MSN, RN, FNP-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5012 S US HIGHWAY 75 STE 300
Mailing Address - Street 2:ATTN. BILLING
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-4589
Mailing Address - Country:US
Mailing Address - Phone:903-416-6325
Mailing Address - Fax:903-416-6326
Practice Address - Street 1:5012 S US HIGHWAY 75
Practice Address - Street 2:SUITE 100
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-4587
Practice Address - Country:US
Practice Address - Phone:903-416-6325
Practice Address - Fax:903-416-6326
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2020-02-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXAP125104363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200582990AMedicaid
TX350029YSYFMedicare PIN