MEDICARE: HAYLEY PETRIE RN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN.1001587-NP	CO

General Provider Information

NPI Number	:	1396582409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAYLEY PETRIE RN

Provider Business Mailing Address
First Line	:	6087 S QUEBEC ST STE 200
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80111-4541
Country	:	US
Telephone Number	:	303-406-0784
Fax Number	:

Provider Business Practice Location Address
First Line	:	6087 S QUEBEC ST STE 200
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80111-4541
Country	:	US
Telephone Number	:	303-406-0784
Fax Number	:

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

Provider Enumeration Date	:	07/15/2024
Last Update Date	:	05/04/2026

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Directions to “ HAYLEY PETRIE RN” Practice Location

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