HAILEY DANIELS KELLY (NPI# 1154951739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154951739 |
| Entity Type | Individual |
| Full Name | HAILEY DANIELS KELLY |
| Other Name | HAILEY DANIELS |
| Credential | PA-C |
| Practice Address |
1325 E Fortification St Jackson MS 39202-2442 |
| Mailing Address |
2010 Highpointe Dr Apt 187 Brandon MS 39042-2924 |
| Practice Telephone | 6013544488 |
| Mailing Telephone | 6019519070 |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2020-07-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA00468 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568014470 | Hailey Marie Kelly | Technician/Technologist | 32100 Telegraph Rd Ste 205, Bingham Farms, MI 48025-2454 | 2019-07-10 |
| Street Address |
1325 E FORTIFICATION ST |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-2442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386632560 | Chris Phillip Ethridge | Orthopaedic Surgery | 1325 E Fortification St, Jackson, MS 39202-2442 | 2005-10-11 |
| 1144832130 | Georgiana Ogletree | Occupational Therapist | 1325 E Fortification St, Jackson, MS 39202-2442 | 2020-08-20 |
| 1972133353 | Justin Bryant Schopp | Physician Assistant | 1325 E Fortification St, Jackson, MS 39202-2442 | 2020-01-24 |
| 1356903520 | James Logan Ferrell | Occupational Therapist | 1325 E Fortification St, Jackson, MS 39202-2442 | 2019-07-08 |
| 1184185472 | Jamie Jackson Garrett | Physician Assistant | 1325 E Fortification St, Jackson, MS 39202-2442 | 2019-03-28 |
| 1114494754 | Charles Taylor Knapp | Nurse Practitioner | 1325 E Fortification St, Jackson, MS 39202-2442 | 2018-11-01 |
| 1477078277 | Leah Winstead West | Physical Medicine & Rehabilitation | 1325 E Fortification St, Jackson, MS 39202-2442 | 2017-08-14 |
| 1700309374 | Van Treece Woodall | Specialist/Technologist | 1325 E Fortification St, Jackson, MS 39202-2442 | 2017-07-25 |
| 1346760220 | Megan Wallace Tyson | Nurse Practitioner | 1325 E Fortification St, Jackson, MS 39202-2442 | 2017-06-22 |
| 1083149181 | John Causey | Registered Nurse | 1325 E Fortification St, Jackson, MS 39202-2442 | 2017-04-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1750868691 | Katherine Walters | Nurse Practitioner | 501 Marshall St., Suite 400, Jackson, MS 39202 | 2018-07-24 |
| 1932638749 | Tylan Lee | Social Worker | 860 East River Place Suite 100, Jackson, MS 39202 | 2017-06-06 |
| 1417314725 | Euna Jyles | Counselor | 860 E River Pl, Jackson, MS 39202 | 2016-01-19 |
| 1255712048 | Edward Jonathan Breight | Specialist/Technologist | 1325 East Fortication Street, Jackson, MS 39202 | 2015-06-17 |
| 1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
| 1477876530 | Mick Inc. | Technician | 334 Josanna Street, Suite #209, Jackson, MS 39202 | 2010-03-03 |
| 1073724910 | Paul Frederic Dare | Anesthesiology | 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 | 2007-05-24 |
| 1225247703 | Lynn Kincannon Holland | Counselor | 911 Manship Street, Unit A, Jackson, MS 39202 | 2007-05-22 |
| 1457568149 | Incare Inc | Pulmonary Function Technologist | 1151 North State St, Suite 406, Jackson, MS 39202 | 2007-05-16 |
| Find all providers in zip 39202 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477091742 | Madeline Grace Daniels | Physician Assistant | 501 Marshall St Ste 400, Jackson, MS 39202-1687 | 2017-02-07 |
| 1972133353 | Justin Bryant Schopp | Physician Assistant | 1325 E Fortification St, Jackson, MS 39202-2442 | 2020-01-24 |
| 1275163727 | Kaitlin Lehto | Physician Assistant | 971 Lakeland Dr Ste 1460, Jackson, MS 39216-4684 | 2020-01-23 |
| 1205466984 | Rachel Sellers | Physician Assistant | 971 Lakeland Dr Ste 1460, Jackson, MS 39216-4621 | 2020-01-22 |
| 1194284786 | Kaitlyn Dunbar | Physician Assistant | 2500 N State St, Jackson, MS 39216-4500 | 2019-03-14 |
| 1164920930 | Catherine Supple Bryant | Physician Assistant | 1190 N State St Ste 502, Jackson, MS 39202-2414 | 2018-01-26 |
| 1790293496 | Madison Holcomb | Physician Assistant | 971 Lakeland Dr Ste 1460, Jackson, MS 39216-4621 | 2018-01-16 |
| 1902314693 | Sarah Lindsey Abdeen | Physician Assistant | 971 Lakeland Dr Ste 1460, Jackson, MS 39216-4621 | 2018-01-16 |
| 1083073233 | Mary Allison Durr | Physician Assistant | 1325 E Fortification St, Jackson, MS 39202-2442 | 2016-02-16 |
| 1104283068 | Heather Morris | Physician Assistant | 1190 N State St Ste 502, Jackson, MS 39202-2414 | 2016-01-24 |
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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.