Provider Demographics
NPI:1811975675
Name:HALEY, KATHLEEN VALARIE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:VALARIE
Last Name:HALEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:KATHLEEN
Other - Middle Name:VALARIE
Other - Last Name:FUTRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:289 IRELAND AVE
Mailing Address - Street 2:IRELAND ARMY COMMUNITY HOSPITAL
Mailing Address - City:FORT KNOX
Mailing Address - State:KY
Mailing Address - Zip Code:40121-5111
Mailing Address - Country:US
Mailing Address - Phone:502-624-0424
Mailing Address - Fax:502-624-0261
Practice Address - Street 1:289 IRELAND AVE
Practice Address - Street 2:IRELAND ARMY COMMUNITY HOSPITAL
Practice Address - City:FORT KNOX
Practice Address - State:KY
Practice Address - Zip Code:40121-5111
Practice Address - Country:US
Practice Address - Phone:502-624-0424
Practice Address - Fax:502-624-0261
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2270363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner