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General NPI Number Information
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NPI Number | 1962204933
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Entity Type | Individual
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Provider Name | HALEY BRINKLEY APRN
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Gender | Female
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 3111 WILLIAMSON COUNTY PKWY
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City | MARION
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State | IL
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Zip | 62959-5235
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Country | US
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Telephone | 618-519-9200
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Fax | 618-985-9155
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Provider Business Mailing Address
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Address Line | 109 CALIFORNIA ST PO BOX 577
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City | CARTERVILLE
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State | IL
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Zip | 62918
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Country | US
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Telephone | 618-519-9200
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Fax | 618-985-4635
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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 | 209.032006
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License Number State | IL
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