Healthcare Provider Details

I. General information

NPI: 1033737960
Provider Name (Legal Business Name): HALEY CANTRELL ADKINS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3114 BROWNS MILL RD
JOHNSON CITY TN
37604-1417
US

IV. Provider business mailing address

1087 CARRIAGE HILLS PL
JOHNSON CITY TN
37604-2360
US

V. Phone/Fax

Practice location:
  • Phone: 423-631-0432
  • Fax:
Mailing address:
  • Phone: 276-220-3661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024179642
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: