Provider Demographics
NPI:1427742295
Name:TERRELL, HAILEY NICOLE
Entity type:Individual
Prefix:MS
First Name:HAILEY
Middle Name:NICOLE
Last Name:TERRELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 CANYON BLVD # 47
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-6748
Mailing Address - Country:US
Mailing Address - Phone:720-245-1787
Mailing Address - Fax:
Practice Address - Street 1:2660 CANYON BLVD # 47
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-6748
Practice Address - Country:US
Practice Address - Phone:720-245-1787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist