Provider Demographics
NPI:1841845229
Name:MYERS, HALEIGH WELLS (PA)
Entity type:Individual
Prefix:
First Name:HALEIGH
Middle Name:WELLS
Last Name:MYERS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:HALEIGH
Other - Middle Name:NICOLE
Other - Last Name:WELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:222 E DUNBAR LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-3170
Mailing Address - Country:US
Mailing Address - Phone:225-978-1788
Mailing Address - Fax:
Practice Address - Street 1:2713 S 74TH ST
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5170
Practice Address - Country:US
Practice Address - Phone:479-573-3723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant