Provider Demographics
NPI:1124902606
Name:HALEY, FLORA DENISE GRAY (FNP)
Entity type:Individual
Prefix:
First Name:FLORA
Middle Name:DENISE GRAY
Last Name:HALEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:FLORA
Other - Middle Name:DENISE
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2021 ELIZABETH CHAPMAN DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39212-3252
Mailing Address - Country:US
Mailing Address - Phone:601-906-9680
Mailing Address - Fax:
Practice Address - Street 1:2021 ELIZABETH CHAPMAN DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39212-3252
Practice Address - Country:US
Practice Address - Phone:601-906-9680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS907636363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily