Provider Demographics
NPI:1841736105
Name:BILLINGSLEY, HAYLEY
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:
Last Name:BILLINGSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 W GRACE ST
Mailing Address - Street 2:APT 3
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-1932
Mailing Address - Country:US
Mailing Address - Phone:540-414-1681
Mailing Address - Fax:
Practice Address - Street 1:1200 E BROAD ST
Practice Address - Street 2:WEST HOSPITAL, 5TH FLOOR, ROOM 520
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5058
Practice Address - Country:US
Practice Address - Phone:540-414-1681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered