Haley, Johnathan Nathaniel

Haley, Johnathan Nathaniel is an individual health care provider with primary practice located at 1325 Spring St , Greenwood SC 29646-3860. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Haley, Johnathan Nathaniel can be contacted via phone (864) 725-4111.

Contact Information

Primary practice address
1325 Spring St Greenwood SC 29646-3860
Phone: (864) 725-4111
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 3511 South Carolina

Profile Details

NPI number 1780856047
LBN Legal business name Haley, Johnathan Nathaniel
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2008
Last updated Mar 15th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780856047 NPPES
South Carolina MEDICAID AN1690

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