Healthcare Provider Details

I. General information

NPI: 1790261055
Provider Name (Legal Business Name): HALEY SEIFERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2018
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 WHITTLESEY RD
COLUMBUS GA
31909-3011
US

IV. Provider business mailing address

407 PLANTATION CREEK RD
FORTSON GA
31808-3851
US

V. Phone/Fax

Practice location:
  • Phone: 706-653-6344
  • Fax:
Mailing address:
  • Phone: 706-442-8559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberRN231944
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberRN231944
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN231944
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: