Healthcare Provider Details

I. General information

NPI: 1245047414
Provider Name (Legal Business Name): HALEY ELIZABETH SHEALY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2024
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3093 SC-14, SUITE 103
GREER SC
29650
US

IV. Provider business mailing address

124 VERDAE BLVD STE 302
GREENVILLE SC
29607-3849
US

V. Phone/Fax

Practice location:
  • Phone: 864-334-0141
  • Fax: 864-334-0137
Mailing address:
  • Phone: 864-334-0141
  • Fax: 864-334-0137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number29638
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number29638
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: