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General NPI Number Information
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NPI Number | 1861909251
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Entity Type | Individual
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Provider Name | HALEY REYNOLDS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/07/2018
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 5400 RIVERSIDE DR STE 202
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City | MACON
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State | GA
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Zip | 31210-0818
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Country | US
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Telephone | 855-228-4597
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Fax | 855-428-4597
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Provider Business Mailing Address
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Address Line | 2300 NORTHSIDE XING STE B
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City | MACON
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State | GA
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Zip | 31210-2254
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Country | US
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Telephone | 904-315-0746
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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 | RN237303
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License Number State | GA
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