Healthcare Provider Details

I. General information

NPI: 1992638381
Provider Name (Legal Business Name): HAYLEE MOORE APRN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 PARKWAY CIR STE 550
SPRINGDALE AR
72762-6362
US

IV. Provider business mailing address

3769 PINECREST ST
SPRINGDALE AR
72764-3266
US

V. Phone/Fax

Practice location:
  • Phone: 479-346-1850
  • Fax:
Mailing address:
  • Phone: 479-883-3086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number219578
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: