Healthcare Provider Details

I. General information

NPI: 1780342147
Provider Name (Legal Business Name): HALEY LEE RODRIGUEZ PA-C, CCSH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HALEY LEE HILL PA-C, CCSH

II. Dates (important events)

Enumeration Date: 12/02/2021
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7330 N 99TH AVE STE 325
GLENDALE AZ
85307-3022
US

IV. Provider business mailing address

19716 W MULBERRY DR
BUCKEYE AZ
85396-5484
US

V. Phone/Fax

Practice location:
  • Phone: 602-633-6070
  • Fax: 602-633-6079
Mailing address:
  • Phone: 480-215-8480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number8914
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number8914
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: