Individual
STEPHEN MARK HALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1863 CR 5300, COFFEYVILLE, KS 67337-8301
(620) 251-4145
Mailing address
4374D CR 2400, COFFEYVILLE, KS 67337-7907
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
1-14408
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-14408
KS STATE BOARD OF PHARMACY
KS
Enumeration date
08/26/2018
Last updated
08/26/2018
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