MEDICARE: HALEY HERNANDEZ

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1841920840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEY HERNANDEZ

Provider Business Mailing Address
First Line	:	1410 4TH STREET DR NW STE 102
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28601-2573
Country	:	US
Telephone Number	:	828-784-0195
Fax Number	:	828-372-4528

Provider Business Practice Location Address
First Line	:	345 4TH ST NW
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28601-4985
Country	:	US
Telephone Number	:	828-544-5101
Fax Number	:	971-239-4271

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

Provider Enumeration Date	:	06/13/2022
Last Update Date	:	01/02/2026

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Directions to “ HALEY HERNANDEZ ” Practice Location

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