Active NPI
Shirley Catherine Haley, CFNP
- Family Nurse Practitioner
- Vincennes, IN
National Provider Identifier
1265637292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71000028A
- Practice address
- 328 N 2ND St
Ste 205
Vincennes, IN 47591 - Phone
- (812) 895-8000
- Fax
- (812) 895-8006
- NPI assigned
- Jun 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71000028A | IN | Primary |
Addresses
Primary practice location
328 N 2ND St
Ste 205
Vincennes, IN 47591
Mailing address
328 N 2ND St
Ste 205
Vincennes, IN 47591
Phone (812) 895-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200442400 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71000028A | IN | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234742400000",
"number": "1265637292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "328 N 2ND ST",
"address_2": "STE 205",
"city": "VINCENNES",
"state": "IN",
"postal_code": "47591",
"telephone_number": "812-895-8000",
"fax_number": "812-895-8006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "328 N 2ND ST",
"address_2": "STE 205",
"city": "VINCENNES",
"state": "IN",
"postal_code": "47591",
"telephone_number": "812-895-8000",
"fax_number": "812-895-8006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALEY",
"first_name": "SHIRLEY",
"middle_name": "CATHERINE",
"credential": "CFNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-19",
"last_updated": "2009-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71000028A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200442400",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vincennes, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.