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Individual

HALEY WILLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
4825 MACCORKLE AVE SW STE F, SOUTH CHARLESTON, WV 25309-1365
(304) 346-9667
(304) 346-9717
Mailing address
1987 LONGMEADOW DR, CHARLESTON, WV 25320-9523
(304) 531-3323

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
39756
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
236
WV
01
568946544
BCBS
WV
01
5874
HEALTH PARTNERS
WV
Enumeration date
06/20/2023
Last updated
06/20/2023
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