Provider Demographics
NPI:1942591052
Name:PATTON, HALEY BROOKE (PA)
Entity Type:Individual
Prefix:MS
First Name:HALEY
Middle Name:BROOKE
Last Name:PATTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:BROOKE
Other - Last Name:HUBBARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:2580 CONSTITUTION BLVD
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1294
Mailing Address - Country:US
Mailing Address - Phone:724-773-6840
Mailing Address - Fax:
Practice Address - Street 1:2580 CONSTITUTION BLVD
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-1294
Practice Address - Country:US
Practice Address - Phone:724-773-6840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-22
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21526363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant