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General NPI Number Information
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NPI Number | 1184248791
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Entity Type | Individual
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Provider Name | HALEY THOMAS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/31/2020
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 507 N LAUREL ST
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City | SUMMERVILLE
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State | SC
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Zip | 29483-6558
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Country | US
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Telephone | 720-879-7128
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Fax |
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Provider Business Mailing Address
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Address Line | 507 N LAUREL ST
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City | SUMMERVILLE
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State | SC
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Zip | 29483-6558
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Country | US
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Telephone | 720-879-7128
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1116833
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 30401
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.0102036-NP
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License Number State | CO
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