Individual
MS. HALEY SUE BACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, PMHNP-BC
Contact information
Practice address
601 DOE RUN DR, SUITE 5, MOUNT STERLING, KY 40353-8880
(859) 432-3055
(859) 432-3044
Mailing address
601 DOE RUN DR, SUITE 5, MOUNT STERLING, KY 40353-8880
(859) 432-3055
(859) 432-3044
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1167776
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4023046
KY
Other
Enumeration date
01/06/2022
Last updated
07/19/2024
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