Provider Demographics
NPI:1295595015
Name:KITCHENS, HALEY DANIELLE
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:DANIELLE
Last Name:KITCHENS
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 1:3212 WEEPING WILLOW CT
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-7439
Mailing Address - Country:US
Mailing Address - Phone:972-363-5015
Mailing Address - Fax:
Practice Address - Street 1:3212 WEEPING WILLOW CT
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-7439
Practice Address - Country:US
Practice Address - Phone:972-363-5015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1155587207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine