Healthcare Provider Details

I. General information

NPI: 1205504685
Provider Name (Legal Business Name): HALEY BRUER FIELLAND MMS, PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HALEY GOLDSTON BRUER

II. Dates (important events)

Enumeration Date: 09/01/2021
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 N MECKLENBURG AVE
SOUTH HILL VA
23970-4080
US

IV. Provider business mailing address

1401 JOHNSTON WILLIS DR
NORTH CHESTERFIELD VA
23235-4730
US

V. Phone/Fax

Practice location:
  • Phone: 434-447-3151
  • Fax: 434-584-5023
Mailing address:
  • Phone: 865-803-3773
  • Fax: 804-483-6491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110008096
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: