Provider Demographics
NPI:1841150984
Name:HANEY, HALEY
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:HANEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 986500
Mailing Address - Street 2:DEPT 3580
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02298-6500
Mailing Address - Country:US
Mailing Address - Phone:203-901-2493
Mailing Address - Fax:866-497-2991
Practice Address - Street 1:1202 NE MCCLAIN RD BLDG 7
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3875
Practice Address - Country:US
Practice Address - Phone:203-901-2493
Practice Address - Fax:866-497-2991
Is Sole Proprietor?:No
Enumeration Date:2025-11-12
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAPRN-CNP235215363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily