Healthcare Provider Details

I. General information

NPI: 1134046501
Provider Name (Legal Business Name): HALEY PATRICIA NEWKIRK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 UNDERWOOD ST
ORLANDO FL
32806-1110
US

IV. Provider business mailing address

246 OAK PARK PL
CASSELBERRY FL
32707-3368
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-4344
  • Fax:
Mailing address:
  • Phone: 912-222-2218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number9331166
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: