Healthcare Provider Details

I. General information

NPI: 1679248041
Provider Name (Legal Business Name): HALEY HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2021
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 WORNALL RD
KANSAS CITY MO
64111-3241
US

IV. Provider business mailing address

5450 ROSEWOOD ST
ROELAND PARK KS
66205-2154
US

V. Phone/Fax

Practice location:
  • Phone: 816-932-2000
  • Fax:
Mailing address:
  • Phone: 402-203-7856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2021031068
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number2018016022
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: