MEDICARE: HAILEY CAMERON PETERSON FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	5023687	NC

General Provider Information

NPI Number	:	1841156536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAILEY CAMERON PETERSON FNP-C

Provider Business Mailing Address
First Line	:	5997 BOLLINGER LOOP
Second Line	:
City	:	MORGANTON
State	:	NC
Zip	:	28655-8829
Country	:	US
Telephone Number	:	828-391-3813
Fax Number	:

Provider Business Practice Location Address
First Line	:	721D MALCOLM BLVD
Second Line	:
City	:	CONNELLY SPRINGS
State	:	NC
Zip	:	28612-7920
Country	:	US
Telephone Number	:	828-522-1290
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2025
Last Update Date	:	12/27/2025

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