Provider Demographics
NPI:1134750524
Name:EVERALL, HALLEY (CNM)
Entity type:Individual
Prefix:
First Name:HALLEY
Middle Name:
Last Name:EVERALL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 MCINTOSH DR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-1633
Mailing Address - Country:US
Mailing Address - Phone:720-231-9201
Mailing Address - Fax:
Practice Address - Street 1:2030 MOUNTAIN VIEW AVE STE 400
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3182
Practice Address - Country:US
Practice Address - Phone:303-315-0400
Practice Address - Fax:303-586-4591
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1632344163WX0003X
COAPN.0995344-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient