Provider Demographics
NPI:1457034852
Name:PLESKOW, HALEY MICHELLE (MSN, RN,CRNP,CPNP-PC)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:MICHELLE
Last Name:PLESKOW
Suffix:
Gender:F
Credentials:MSN, RN,CRNP,CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3329
Mailing Address - Country:US
Mailing Address - Phone:954-798-5478
Mailing Address - Fax:
Practice Address - Street 1:3550 MARKET ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3329
Practice Address - Country:US
Practice Address - Phone:954-798-5478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028016363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics