Provider Demographics
NPI:1659019503
Name:SULLIVAN, HALEY NICOLE (CERTIFIED DOULA)
Entity Type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:NICOLE
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:CERTIFIED DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-7836
Mailing Address - Country:US
Mailing Address - Phone:602-377-5350
Mailing Address - Fax:
Practice Address - Street 1:353 CAMINO REAL
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-7836
Practice Address - Country:US
Practice Address - Phone:602-377-5350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula