Provider Demographics
NPI:1427334739
Name:HALLEY, LAURA RACHEL (NP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:RACHEL
Last Name:HALLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 ALBANY AVE
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:WY
Mailing Address - Zip Code:82240-1530
Mailing Address - Country:US
Mailing Address - Phone:307-532-2107
Mailing Address - Fax:
Practice Address - Street 1:625 ALBANY AVE
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:WY
Practice Address - Zip Code:82240-1530
Practice Address - Country:US
Practice Address - Phone:307-532-2107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY16668.1140363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily