Individual
HALEY NICOLE SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3921 SUNSET RIDGE RD STE 201, RALEIGH, NC 27607-6679
(919) 372-3099
Mailing address
4679 JAMES ROYSTER RD, OXFORD, NC 27565-7444
(919) 939-0418
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-13311
NC
363AS0400X
Surgical Physician Assistant
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Other
Enumeration date
07/05/2023
Last updated
07/06/2023
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