Individual
JOHNATHAN NATHANIEL HALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1325 SPRING ST, GREENWOOD, SC 29646-3860
(864) 725-4111
Mailing address
PO BOX 819, GREENWOOD, SC 29648-0819
(706) 860-2701
(706) 737-2271
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3511
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN1690
—
SC
Enumeration date
03/27/2008
Last updated
03/15/2024
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