Provider Demographics
NPI:1699317941
Name:WHITE, HALEY DARYL (CRNP)
Entity type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:DARYL
Last Name:WHITE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:HALEY
Other - Middle Name:DARYL
Other - Last Name:DAVENPORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:192 BELMONT WAY
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:AL
Mailing Address - Zip Code:35043-7613
Mailing Address - Country:US
Mailing Address - Phone:205-482-5562
Mailing Address - Fax:
Practice Address - Street 1:615 18TH ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1826
Practice Address - Country:US
Practice Address - Phone:205-934-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-153447363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care