Provider Demographics
NPI:1669627279
Name:URSIC, HALEY H (FNP)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:H
Last Name:URSIC
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 331049
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-7508
Mailing Address - Country:US
Mailing Address - Phone:615-340-4000
Mailing Address - Fax:615-327-4449
Practice Address - Street 1:2004 HAYES ST STE 600
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2663
Practice Address - Country:US
Practice Address - Phone:615-340-4000
Practice Address - Fax:615-327-4449
Is Sole Proprietor?:No
Enumeration Date:2008-11-24
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN13725363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3342431Medicare PIN