Healthcare Provider Details

I. General information

NPI: 1982824926
Provider Name (Legal Business Name): THANIA HANEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2177 ASHEVILLE RD
WAYNESVILLE NC
28786-3139
US

IV. Provider business mailing address

PO BOX 1703
CLYDE NC
28721-1703
US

V. Phone/Fax

Practice location:
  • Phone: 828-452-6675
  • Fax:
Mailing address:
  • Phone: 828-452-6675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number196701
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: