Provider Demographics
NPI:1952958647
Name:QUINLAN, HALEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:QUINLAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 W US HIGHWAY 79
Mailing Address - Street 2:
Mailing Address - City:ROCKDALE
Mailing Address - State:TX
Mailing Address - Zip Code:76567-5325
Mailing Address - Country:US
Mailing Address - Phone:512-446-3401
Mailing Address - Fax:
Practice Address - Street 1:709 W US HIGHWAY 79
Practice Address - Street 2:
Practice Address - City:ROCKDALE
Practice Address - State:TX
Practice Address - Zip Code:76567-5325
Practice Address - Country:US
Practice Address - Phone:512-446-3401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62745183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist