Provider Demographics
NPI:1699170720
Name:MINER, HAYLEY MAE
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:MAE
Last Name:MINER
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 1:2280 E CALVADA BLVD
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-5873
Mailing Address - Country:US
Mailing Address - Phone:775-400-9666
Mailing Address - Fax:
Practice Address - Street 1:2280 E CALVADA BLVD STE 301
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-5877
Practice Address - Country:US
Practice Address - Phone:755-400-9666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-31
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner