Khristan Heagle Haller, DNP, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

383126 Issued in NY

Practice address

20 Locust LN
Bronxville, NY 10708-4933

Phone

(917) 612-3781

NPI assigned

Sep 1, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Khristan Heagle Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1134733710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 LOCUST LN",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107084933",
            "telephone_number": "917-612-3781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 LOCUST LN",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107084933",
            "telephone_number": "917-612-3781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAGLE HALLER",
        "first_name": "KHRISTAN",
        "name_prefix": "Dr.",
        "credential": "DNP, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "383126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KHRISTAN",
            "last_name": "HEAGLE",
            "prefix": "DR.",
            "credential": "DNP, APRN, CPNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Niamh Hartnett
• Sue Lynn Hartwell, MSE
• Hasan Asif, MD PC
• Emi Hayashi, MD
• Alexis Hazard
• Jamie Heller
• Ennique Henriques
• Julianna Higgins, PA-C
• Mary L. Hoffman, LCSW-R
• Zahra Hojati, PHARM D

• Pediatric Nurse Practitioner in Bronxville, NY
• Providers in Bronxville, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.