Healthcare Provider Details

I. General information

NPI: 1073286613
Provider Name (Legal Business Name): HAILEY LYNN HARRIS PNPAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HAILEY HARRIS HAILEY WEEKS

II. Dates (important events)

Enumeration Date: 07/29/2021
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ERWIN RD
DURHAM NC
27705-4699
US

IV. Provider business mailing address

718 RED FOREST TRL
RALEIGH NC
27615-4841
US

V. Phone/Fax

Practice location:
  • Phone: 919-691-2916
  • Fax:
Mailing address:
  • Phone: 810-220-9640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number5014645
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5014645
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: