Healthcare Provider Details

I. General information

NPI: 1124945910
Provider Name (Legal Business Name): HALEY SHATTO ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW
WASHINGTON DC
20010-3017
US

IV. Provider business mailing address

1001 N VERMONT ST APT 908
ARLINGTON VA
22201-4768
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-3281
  • Fax:
Mailing address:
  • Phone: 913-940-4495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberNP200001669
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: