Healthcare Provider Details

I. General information

NPI: 1568110831
Provider Name (Legal Business Name): HALEY PRICE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2022
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 TOWN CENTER PKWY STE 400
RESTON VA
20190-3300
US

IV. Provider business mailing address

1850 TOWN CENTER PKWY STE 400
RESTON VA
20190-3300
US

V. Phone/Fax

Practice location:
  • Phone: 703-277-2663
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: