Healthcare Provider Details

I. General information

NPI: 1114280633
Provider Name (Legal Business Name): HALEY MOORE HAUGHT F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2012
Last Update Date: 05/27/2021
Certification Date: 05/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 BROADWAY ST
DELHI LA
71232-3001
US

IV. Provider business mailing address

407 CINCINNATI ST
DELHI LA
71232-3007
US

V. Phone/Fax

Practice location:
  • Phone: 318-878-6650
  • Fax: 318-878-6657
Mailing address:
  • Phone: 318-878-6432
  • Fax: 318-878-8638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number06861
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: