Provider Demographics
NPI:1720324874
Name:HEWLETT, HALEY FAITH (APRN)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:FAITH
Last Name:HEWLETT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:FAITH
Other - Last Name:TALIAFERRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:3101 SE 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4900
Mailing Address - Country:US
Mailing Address - Phone:479-636-9234
Mailing Address - Fax:479-636-0774
Practice Address - Street 1:3101 SE 14TH ST
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-4900
Practice Address - Country:US
Practice Address - Phone:479-636-9234
Practice Address - Fax:479-636-0774
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA003731363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner