Haylie Pham, NP
Individual provider Active NPI Family Nurse Practitioner · Pevely, MO
NPI 1245180751 · NPPES record last updated Feb 3, 2026
Key facts
- NPI
- 1245180751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 95243342 (CA)
- Practice address
- 1940 Magnolia Way
Pevely, MO 63070-1339 - Phone
- (314) 203-6468
- NPI assigned
- Feb 3, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019025077 | MO | MD | Registered Nurse |
| 95243342 | CA | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 95243342 | CA | |
| Registered Nurse | 163W00000X | 2019025077 | MO | |
| Family Nurse Practitioner | 363LF0000X | 95243342 | CA | Yes |
Addresses
Primary practice location
1940 Magnolia Way
Pevely, MO 63070-1339
Mailing address
1940 Magnolia Way
Pevely, MO 63070-1339
Phone (314) 203-6468
Other providers in Pevely, MO
- Kinematic Concepts LLC
- Madonna Ann McFarland
- Emily Paszkiewicz
- Pevely RX
- Pevely RX
- Hollie Marie Roedel
- Todd Wind DDS Dba Pevely Family Dentistry
- Kelly N Uding
- Victoria Lynn Viehman
- Jodi M. Walker
All providers in Pevely, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.