Haley Cook, APRN, FNP
Individual provider Active NPI Family Medicine Physician · Jasper, GA
NPI 1366940876 · NPPES record last updated Jan 30, 2018
Key facts
- NPI
- 1366940876
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- RN175358 (GA)
- Practice address
- 175 Samaritan Dr
Jasper, GA 30143-1964 - Phone
- (706) 253-4673
- NPI assigned
- Jan 30, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200807000579 | GA | Practitioner - Nurse Practitioner | 8527483577 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | RN175358 | GA | Yes |
Addresses
Primary practice location
175 Samaritan Dr
Jasper, GA 30143-1964
Mailing address
2256 Brick Mill Rd
Canton, GA 30115-9125
Other providers in Jasper, GA
- Kevin Michael Collins
- Complete Health Diagnostics, Inc.
- Comprehensive Health Care of North Georgia, P.C.
- Connect Hearing, Inc
- James Wesley Conner
- Lynn Cooper
- Leslie G Cornelison
- Kristen Elizabeth Cornelius
- Wanda Denise Correia
- Coster Care
All providers in Jasper, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.