Provider Demographics
NPI:1235936840
Name:SMITH, HALEY NICOLE (CRNA)
Entity type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:NICOLE
Last Name:SMITH
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:NICOLE
Other - Last Name:MADEWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27 TROPHY RDG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-7715
Mailing Address - Country:US
Mailing Address - Phone:432-889-3435
Mailing Address - Fax:
Practice Address - Street 1:9522 HUEBNER RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1548
Practice Address - Country:US
Practice Address - Phone:210-478-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-01
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX978088367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered