Provider Demographics
NPI:1619495348
Name:ENTREKIN, HAYLEY GRAHAM (CRNP)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:GRAHAM
Last Name:ENTREKIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2336 DERBY DR
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35216-4263
Mailing Address - Country:US
Mailing Address - Phone:256-310-2084
Mailing Address - Fax:
Practice Address - Street 1:500 22ND ST S STE 506
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-3110
Practice Address - Country:US
Practice Address - Phone:205-801-9039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-138585363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care