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Individual

HALEY B. QUEEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501
(770) 219-9000
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
006086
GA
363AS0400X
Surgical Physician Assistant

Other

Enumeration date
01/26/2011
Last updated
01/22/2021
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