Healthcare Provider Details

I. General information

NPI: 1003740713
Provider Name (Legal Business Name): TAMARA HALEY MS, CEP, CDCES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 TANGLEWOOD DR
FLOYDS KNOBS IN
47119-9222
US

IV. Provider business mailing address

4050 TANGLEWOOD DR
FLOYDS KNOBS IN
47119-9222
US

V. Phone/Fax

Practice location:
  • Phone: 270-313-9188
  • Fax:
Mailing address:
  • Phone: 270-313-9188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: