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General NPI Number Information
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NPI Number | 1609454883
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Entity Type | Individual
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Provider Name | COLLEEN ROSALIE HANEY AGNP-C, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/30/2021
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 1197 AIRPORT RD STE 2
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City | MILFORD
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State | DE
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Zip | 19963-6491
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Country | US
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Telephone | 23-508-0541
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Fax |
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Provider Business Mailing Address
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Address Line | 1197 AIRPORT RD STE 2
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City | MILFORD
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State | DE
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Zip | 19963-6491
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Country | US
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Telephone |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | LP-0010723
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 95017043
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | L8-0010801
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License Number State | DE
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