Provider Demographics
NPI:1518702786
Name:WILLIAMS, HALEY (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:HALEY
Middle Name:
Last Name:WILLIAMS
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 1:1611 S BALTIMORE ST
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-4518
Mailing Address - Country:US
Mailing Address - Phone:660-665-7575
Mailing Address - Fax:
Practice Address - Street 1:1501 UNION AVE
Practice Address - Street 2:
Practice Address - City:MOBERLY
Practice Address - State:MO
Practice Address - Zip Code:65270-9469
Practice Address - Country:US
Practice Address - Phone:660-263-4770
Practice Address - Fax:660-263-2228
Is Sole Proprietor?:No
Enumeration Date:2024-06-28
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20240255722024025572207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine