Provider Demographics
NPI:1255713624
Name:MOON, HALEY (APRN, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:HALEY
Middle Name:
Last Name:MOON
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:558 FLEMING ST STE A
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4216
Mailing Address - Country:US
Mailing Address - Phone:828-484-1801
Mailing Address - Fax:877-349-6373
Practice Address - Street 1:558 FLEMING ST STE A
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4216
Practice Address - Country:US
Practice Address - Phone:828-484-1801
Practice Address - Fax:877-349-6373
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR900592163W00000X
NC352190163W00000X
NC5016432363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse