Provider Demographics
NPI:1962296145
Name:HALEY, CONNIE A
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:A
Last Name:HALEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:CONNIE
Other - Middle Name:LOUISE
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1605 TYNEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-4213
Mailing Address - Country:US
Mailing Address - Phone:615-598-6411
Mailing Address - Fax:
Practice Address - Street 1:1605 TYNEWOOD DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-4213
Practice Address - Country:US
Practice Address - Phone:615-598-6411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35308207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease