Healthcare Provider Details
I. General information
NPI: 1811399520
Provider Name (Legal Business Name): HALEY PATTON DADD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/24/2014
Last Update Date: 12/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
676 441 HISTORIC HWY N
DEMOREST GA
30535-4523
US
IV. Provider business mailing address
329 MURFREESBORO PIKE
NASHVILLE TN
37210-2834
US
V. Phone/Fax
- Phone: 706-499-7291
- Fax: 706-754-0160
- Phone: 615-244-6900
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | RN215782 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LG0600X |
| Taxonomy | Gerontology Nurse Practitioner |
| License Number | APN0000019713 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: