Healthcare Provider Details

I. General information

NPI: 1417810797
Provider Name (Legal Business Name): HAYLEY MEEHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 LAKESIDE DR
LYNCHBURG VA
24501-3113
US

IV. Provider business mailing address

1501 LAKESIDE DR
LYNCHBURG VA
24501-3113
US

V. Phone/Fax

Practice location:
  • Phone: 434-544-8100
  • Fax:
Mailing address:
  • Phone: 434-544-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: