Provider Demographics
NPI:1215264742
Name:HUNTER, HALEY JACKSON (PA-C)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:JACKSON
Last Name:HUNTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:J
Other - Last Name:STEPHENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:107 CONTEMPO AVE. STE. 2
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291
Mailing Address - Country:US
Mailing Address - Phone:318-324-0111
Mailing Address - Fax:
Practice Address - Street 1:107 CONTEMPO AVE. STE. 2
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291
Practice Address - Country:US
Practice Address - Phone:318-324-0111
Practice Address - Fax:318-324-9679
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA.200331363A00000X
LAPA200331RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant