Individual
ALICIA HAISLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1267 HIGHWAY 54 W STE 2200, FAYETTEVILLE, GA 30214-2110
(770) 716-0051
Mailing address
504 VILLAGE PT, FAIRBURN, GA 30213-5100
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
RN230695
GA
363L00000X
Nurse Practitioner
Primary
RN230695
GA
Other
Enumeration date
07/29/2020
Last updated
09/09/2024
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