MEDICARE: HALEY STICKLES

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	124Q00000X	Dental Hygienist	10965	TN

General Provider Information

NPI Number	:	1871324988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEY STICKLES

Provider Business Mailing Address
First Line	:	7345 ALTHORP WAY
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-7017
Country	:	US
Telephone Number	:	586-839-7196
Fax Number	:

Provider Business Practice Location Address
First Line	:	5802 NOLENSVILLE PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-6520
Country	:	US
Telephone Number	:	615-832-5899
Fax Number	:

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

Provider Enumeration Date	:	08/10/2024
Last Update Date	:	08/10/2024

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Directions to “ HALEY STICKLES ” Practice Location

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