Provider Demographics
NPI:1245915842
Name:HALEY, CAILYN RANAE (BSN, RN IBCLC)
Entity type:Individual
Prefix:MRS
First Name:CAILYN
Middle Name:RANAE
Last Name:HALEY
Suffix:
Gender:F
Credentials:BSN, RN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 NE CATAWBA RD
Mailing Address - Street 2:
Mailing Address - City:BRAYMER
Mailing Address - State:MO
Mailing Address - Zip Code:64624-7107
Mailing Address - Country:US
Mailing Address - Phone:816-206-8642
Mailing Address - Fax:
Practice Address - Street 1:79 NE CATAWBA RD
Practice Address - Street 2:
Practice Address - City:BRAYMER
Practice Address - State:MO
Practice Address - Zip Code:64624-7107
Practice Address - Country:US
Practice Address - Phone:816-206-8642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008005974163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant