Provider Demographics
NPI:1568037562
Name:GILL, HAYLEY (RN)
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:
Last Name:GILL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 ENTERPRISE ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-5463
Mailing Address - Country:US
Mailing Address - Phone:903-230-8110
Mailing Address - Fax:
Practice Address - Street 1:403 ENTERPRISE ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-5463
Practice Address - Country:US
Practice Address - Phone:903-230-8110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1009581163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0200XNursing Service ProvidersRegistered NursePediatricsGroup - Single Specialty