Basic Information
| Provider Information | |||||||||
| NPI: | 1013151539 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAYMANCE | ||||||||
| FirstName: | HALEY | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1932 ALCOA HWY STE 270 | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379201537 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8652514658 | ||||||||
| FaxNumber: | 8652514659 | ||||||||
| Practice Location | |||||||||
| Address1: | 2497 S ROANE ST | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | HARRIMAN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 377488670 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8658822909 | ||||||||
| FaxNumber: | 8658822890 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2009 | ||||||||
| LastUpdateDate: | 04/16/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 14131 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 3345502 | 05 | TN | MEDICAID |