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Individual

HAILEY DANIELLE HUMPHREYS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2914 CHEROKEE ST NW STE 1A, KENNESAW, GA 30144-6526
(678) 846-2420
Mailing address
121 COUNTY ROAD 321, NIOTA, TN 37826-3029
(423) 507-3040

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
28142
TN

Other

Enumeration date
03/25/2021
Last updated
03/25/2021
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