Provider Demographics
NPI:1528822251
Name:WATSON, HALEY CHEYENNE (FNP)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:CHEYENNE
Last Name:WATSON
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 1:2608 GREEN ACRES ST
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-9419
Mailing Address - Country:US
Mailing Address - Phone:336-928-0203
Mailing Address - Fax:
Practice Address - Street 1:1041 MORGANTON BLVD SW STE 100
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5605
Practice Address - Country:US
Practice Address - Phone:828-323-2460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NCF04240397363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program