Provider Demographics
NPI:1033863667
Name:ALLEN, HAYLEY ALLISON (PA-C)
Entity type:Individual
Prefix:MRS
First Name:HAYLEY
Middle Name:ALLISON
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:
Other - Last Name:KINCAID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1792 ALYSHEBA WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2285
Mailing Address - Country:US
Mailing Address - Phone:833-401-1577
Mailing Address - Fax:
Practice Address - Street 1:1792 ALYSHEBA WAY STE 200
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2285
Practice Address - Country:US
Practice Address - Phone:833-401-1577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-11
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA2981363A00000X
KY363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant