Basic Information
Provider Information
NPI: 1255778254
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MYERS
FirstName: HALEY
MiddleName: ALISON
NamePrefix: MRS.
NameSuffix:  
Credential: CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: WRIGHT
OtherFirstName: HALEY
OtherMiddleName: ALISON
OtherNamePrefix: MISS
OtherNameSuffix:  
OtherCredential: RN
OtherLastNameType: 1
Mailing Information
Address1: 2620 ELM HILL PIKE
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372143108
CountryCode: US
TelephoneNumber: 6154254200
FaxNumber: 6154254268
Practice Location
Address1: 1585 GEORGESVILLE SQUARE DR
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432283777
CountryCode: US
TelephoneNumber: 6143350030
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/30/2013
LastUpdateDate: 05/30/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XCOA.14503-NPOHY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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