Provider Demographics
NPI:1902151616
Name:QUILLEN, HALEY D (FNP)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:D
Last Name:QUILLEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 E ANDREW JOHNSON HWY
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-0965
Mailing Address - Country:US
Mailing Address - Phone:423-972-4770
Mailing Address - Fax:423-485-6421
Practice Address - Street 1:3225 E ANDREW JOHNSON HWY
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-0965
Practice Address - Country:US
Practice Address - Phone:423-972-4770
Practice Address - Fax:423-485-6421
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16881363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily