Provider Demographics
NPI:1619547478
Name:ROSNERMANZ, HAYLEY LEIGHANN (NP)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:LEIGHANN
Last Name:ROSNERMANZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:L
Other - Last Name:ROSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 CHILDRENS WAY # 653
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3500
Mailing Address - Country:US
Mailing Address - Phone:501-364-1100
Mailing Address - Fax:501-364-4082
Practice Address - Street 1:1080 PATS LN
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-4754
Practice Address - Country:US
Practice Address - Phone:501-326-0901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR215210363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR215210OtherNP LICENSE NUMBER