Healthcare Provider Details

I. General information

NPI: 1497858534
Provider Name (Legal Business Name): HALEY N UKIRI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2610 ENTERPRISE DR
ANDERSON IN
46013-9684
US

IV. Provider business mailing address

3600 W BETHEL AVE
MUNCIE IN
47304-5407
US

V. Phone/Fax

Practice location:
  • Phone: 765-683-4400
  • Fax: 765-213-3713
Mailing address:
  • Phone: 800-622-6575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71003205A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code163WX0800X
TaxonomyOrthopedic Registered Nurse
License Number28144532A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: