Healthcare Provider Details

I. General information

NPI: 1417873472
Provider Name (Legal Business Name): HALEY CANTRELL BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SAINT JOSEPH DR
LEXINGTON KY
40504-3742
US

IV. Provider business mailing address

2482 MINA STATION RD
WINCHESTER KY
40391-9037
US

V. Phone/Fax

Practice location:
  • Phone: 859-313-1176
  • Fax:
Mailing address:
  • Phone: 606-505-7198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number1175840
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: