Healthcare Provider Details

I. General information

NPI: 1396582409
Provider Name (Legal Business Name): HAYLEY PETRIE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HAYLEY PETRIE PMHDNP-BC

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6087 S QUEBEC ST STE 200
CENTENNIAL CO
80111-4541
US

IV. Provider business mailing address

6087 S QUEBEC ST STE 200
CENTENNIAL CO
80111-4541
US

V. Phone/Fax

Practice location:
  • Phone: 303-406-0784
  • Fax:
Mailing address:
  • Phone: 303-406-0784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.1001587-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: