MEDICARE: TAMARA HALEY MS, CEP, CDCES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174H00000X	Health Educator

General Provider Information

NPI Number	:	1003740713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA HALEY MS, CEP, CDCES

Provider Business Mailing Address
First Line	:	4050 TANGLEWOOD DR
Second Line	:
City	:	FLOYDS KNOBS
State	:	IN
Zip	:	47119-9222
Country	:	US
Telephone Number	:	270-313-9188
Fax Number	:

Provider Business Practice Location Address
First Line	:	4050 TANGLEWOOD DR
Second Line	:
City	:	FLOYDS KNOBS
State	:	IN
Zip	:	47119-9222
Country	:	US
Telephone Number	:	270-313-9188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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