Provider Demographics
NPI:1710407853
Name:SCELLICK, HALEY NADENE (ARNP)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:NADENE
Last Name:SCELLICK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 KNIGHT ST STE B
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4257
Mailing Address - Country:US
Mailing Address - Phone:509-392-7047
Mailing Address - Fax:509-436-1944
Practice Address - Street 1:503 KNIGHT ST STE B
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4257
Practice Address - Country:US
Practice Address - Phone:509-392-7047
Practice Address - Fax:509-436-1944
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60757019363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily