Healthcare Provider Details

I. General information

NPI: 1457992935
Provider Name (Legal Business Name): HALEY KRISTINE CROSS MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2019
Last Update Date: 01/12/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2157 S HIGHWAY 27
STEARNS KY
42647-6297
US

IV. Provider business mailing address

100 KINGTOWN SPUR
STRUNK KY
42649-7314
US

V. Phone/Fax

Practice location:
  • Phone: 606-376-9700
  • Fax:
Mailing address:
  • Phone: 423-539-0147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26621
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3015456
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: