Provider Demographics
NPI:1295974178
Name:MESSER, HALEY JOYCE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:JOYCE
Last Name:MESSER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:HALEY
Other - Middle Name:JOYCE
Other - Last Name:DIFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NONE
Mailing Address - Street 1:PSC 79
Mailing Address - Street 2:BOX 226
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09714
Mailing Address - Country:US
Mailing Address - Phone:405-563-2143
Mailing Address - Fax:
Practice Address - Street 1:PSC 79 BOX 226
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09714-0000
Practice Address - Country:US
Practice Address - Phone:405-563-2143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1085462363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant