Provider Demographics
NPI:1164005971
Name:FRIEND, HAILEAH (FNP-BC)
Entity type:Individual
Prefix:
First Name:HAILEAH
Middle Name:
Last Name:FRIEND
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7365 N 800 W
Mailing Address - Street 2:
Mailing Address - City:ORLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46776-9693
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1211 STATELINE RD
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:MI
Practice Address - Zip Code:49120-4729
Practice Address - Country:US
Practice Address - Phone:269-684-2810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-29
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71011090A363LF0000X
MI4704420364363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily