1356034920 NPI number — MRS. HALEY NICOLE OCONNOR RDN, LD,

Table of content: MRS. HALEY NICOLE OCONNOR RDN, LD, (NPI 1356034920)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356034920 NPI number — MRS. HALEY NICOLE OCONNOR RDN, LD,

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OCONNOR
Provider First Name:
HALEY
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RDN, LD,
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356034920
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7631
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOBILE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36670-0631
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-508-5380
Provider Business Mailing Address Fax Number:
251-217-9221

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1015 MONTLIMAR DR UNIT C6
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOBILE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36609-1713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-272-9790
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/31/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  D2454 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 133V00000X , with the licence number: 3004 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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