Basic Information
Provider Information
NPI: 1780044594
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: IRELAND
FirstName: HAILEE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 400 S MAIN ST
Address2: STE 100
City: SEARCY
State: AR
PostalCode: 721437800
CountryCode: US
TelephoneNumber: 5012799000
FaxNumber: 5012799011
Practice Location
Address1: 400 S MAIN ST
Address2: STE 100
City: SEARCY
State: AR
PostalCode: 721437800
CountryCode: US
TelephoneNumber: 5012799000
FaxNumber: 5012799011
Other Information
ProviderEnumerationDate: 03/07/2016
LastUpdateDate: 07/01/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200XA004675ARY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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