Provider Demographics
NPI:1982393492
Name:MATEEN, HAYLEY (CNP)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:
Last Name:MATEEN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:
Other - Last Name:MCCULLOUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:140 COMMONWEALTH AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3625
Mailing Address - Country:US
Mailing Address - Phone:978-762-6262
Mailing Address - Fax:
Practice Address - Street 1:140 COMMONWEALTH AVE STE 202
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3625
Practice Address - Country:US
Practice Address - Phone:978-762-6262
Practice Address - Fax:978-762-6260
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2303028363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily