Healthcare Provider Details

I. General information

NPI: 1699651752
Provider Name (Legal Business Name): HALEY HUYEN VUONG RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MILL RD
NORTH BROOKFIELD MA
01535-1603
US

IV. Provider business mailing address

10 MILL RD
NORTH BROOKFIELD MA
01535-1603
US

V. Phone/Fax

Practice location:
  • Phone: 617-606-1502
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2335980
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: