Provider Demographics
NPI:1396701496
Name:HALEY, RHOBERTA JONES (NP)
Entity type:Individual
Prefix:MS
First Name:RHOBERTA
Middle Name:JONES
Last Name:HALEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-1437
Mailing Address - Country:US
Mailing Address - Phone:765-505-0530
Mailing Address - Fax:765-420-0002
Practice Address - Street 1:502 N UNIVERSITY ST
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47907-2069
Practice Address - Country:US
Practice Address - Phone:765-505-0530
Practice Address - Fax:765-420-0002
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA282803363LF0000X
IN28164718A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily