GLYNNIS J HALEY (NPI# 1063585248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063585248 |
| Entity Type | Individual |
| Full Name | GLYNNIS J HALEY |
| Credential | NP-C |
| Practice Address |
250 Martin Luther King Jr Blvd Macon GA 31201 |
| Mailing Address |
Po Box 4947 Macon GA 31208-4947 |
| Practice Telephone | 4783014111 |
| Practice Fax Number | 4783015812 |
| Mailing Telephone | 4783012362 |
| Mailing Fax Number | 4783012272 |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2014-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN115633 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000934304C | 05 | |
| GA | RAILROAD MEDICARE | 500025995 | 01 |
| Street Address |
250 MARTIN LUTHER KING JR BLVD |
| City | MACON |
| State | GA |
| Zip Code | 31201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669465860 | John Wesley King Jr. | Internal Medicine | 250 Martin Luther King Jr Blvd, Macon, GA 31201-3490 | 2005-08-24 |
| 1194350017 | Michael Caputo | Marriage & Family Therapist | 250 Martin Luther King Jr Blvd, Macon, GA 31201-3490 | 2020-03-11 |
| 1801319447 | Neha Khorana | Psychologist | 250 Martin Luther King Jr Blvd, Macon, GA 31201-3490 | 2017-07-25 |
| 1659818623 | Community Health Care Systems, Inc | Clinic/Center | 250 Martin Luther King Jr Blvd, Macon, GA 31201-3490 | 2017-01-27 |
| 1659716546 | Fanisha Y Porter | Psychiatry & Neurology | 250 Martin Luther King Jr Blvd, Macon, GA 31201 | 2013-05-06 |
| 1679835649 | Joe Sam Robinson IIi | Internal Medicine | 250 Martin Luther King Jr Blvd, Macon, GA 31201 | 2012-06-14 |
| 1831457274 | Stephanie Alexandra Beavers | Internal Medicine | 250 Martin Luther King Jr Blvd, Macon, GA 31201 | 2012-04-23 |
| 1447534441 | Marita Ann Hockstedler | Nurse Practitioner | 250 Martin Luther King Jr Blvd, Macon, GA 31201-0000 | 2011-10-10 |
| 1154602910 | Dinah K Ayna | Psychologist | 250 Martin Luther King Jr Blvd, Macon, GA 31201-3490 | 2011-09-07 |
| 1477708956 | Katherine Walker Hatcher | Nurse Practitioner | 250 Martin Luther King Jr Blvd, Macon, GA 31201-3490 | 2008-11-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639666340 | Yasameen Emad Muzahim | Internal Medicine | 777 Hemlock Street, Msc 165, Macon, GA 31201 | 2018-04-18 |
| 1952819419 | Putnam Dialysis LLC | Clinic/Center | 657 Hemlock Street, Suite 200, Macon, GA 31201 | 2018-01-18 |
| 1730604331 | Graham Arthur Mercier | Surgery | 169 Ashley Ave., Room 202 Main Hospital Msc 333, Charleston, SC 31201 | 2017-08-04 |
| 1376075705 | Diamond Jude | Internal Medicine | 777 Hemlock Street Msc #104, Macon, GA 31201 | 2017-04-03 |
| 1174055263 | Carol Roobin Bashuk | Hearing Instrument Specialist | 634 First Street, Macon, GA 31201 | 2017-03-29 |
| 1144752411 | Hubert Pare | Student in an Organized Health Care Education/Training Program | 777 Hemlock Street, Msc# 165, Macon, GA 31201 | 2017-03-28 |
| 1548613789 | Michael Daugherty | Counselor | 1873 Hardeman Ave, Suite 1, Macon, GA 31201 | 2016-07-22 |
| 1316317993 | 4front Healthcare of Middle Georgia, LLC | Hospice Care, Community Based | 682 1st St, Macon, GA 31201 | 2015-09-25 |
| 1881073054 | Andrew Lee Drahos | Surgery | 777 Hemlock St # 140, Macon, GA 31201 | 2015-05-21 |
| 1720474158 | April Nicole Colley | Nurse Practitioner | 1014 Forsyth Street, Macon, GA 31201 | 2015-04-13 |
| Find all providers in zip 31201 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093315848 | Tracy Tarvers | Nurse Practitioner | 129 Wolf Creek Dr N, Macon, GA 31210-9002 | 2020-10-30 |
| 1578160560 | Ida Mayaka | Nurse Practitioner | 210 Autumn Trace Ct, Macon, GA 31210-8025 | 2020-10-03 |
| 1427664465 | Shanna Lynn Beaulieu | Nurse Practitioner | 781 Spring St Ste 230, Macon, GA 31201-2185 | 2020-09-16 |
| 1467070557 | Raquel Simmons | Nurse Practitioner | 670 Ivy Brook Way, Macon, GA 31210-5520 | 2020-07-06 |
| 1174159800 | Jamie K Polk | Nurse Practitioner | 3951 Ridge Ave Ste C, Macon, GA 31210-5064 | 2020-03-13 |
| 1033743455 | Dana Elizabeth Toth | Nurse Practitioner | 5300 Bowman Rd, Macon, GA 31210 | 2020-02-25 |
| 1730730581 | Lindsay Fernandez | Nurse Practitioner | 102 Saint Johns Pl, Macon, GA 31210-8606 | 2019-09-24 |
| 1003468240 | Skylar Nelson | Nurse Practitioner | 330 Hospital Dr Ste 200, Macon, GA 31217-8034 | 2019-07-09 |
| 1861051880 | Courtney Elizabeth Avery | Nurse Practitioner | 540 Charter Blvd Ste 400, Macon, GA 31210-4882 | 2019-06-12 |
| 1376101196 | Detra K Dixon | Nurse Practitioner | 227 Amalie Dr, Macon, GA 31220-2667 | 2019-06-05 |
| Find all providers in MACON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.