Provider Demographics
NPI:1144944166
Name:ZAHNER, HALEY BROOKE (APRN, CNM)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:BROOKE
Last Name:ZAHNER
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:BROOKE
Other - Last Name:BUSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:PO BOX 772437
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48277-2437
Mailing Address - Country:US
Mailing Address - Phone:317-575-7304
Mailing Address - Fax:317-575-7333
Practice Address - Street 1:1150 LEXINGTON RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8300
Practice Address - Country:US
Practice Address - Phone:859-562-8599
Practice Address - Fax:859-257-1214
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041461647163W00000X
KY3018528367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100859300Medicaid