Provider Demographics
NPI:1720732761
Name:EXLINE, HAYLEY MICHELLE (APRN)
Entity type:Individual
Prefix:MRS
First Name:HAYLEY
Middle Name:MICHELLE
Last Name:EXLINE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:
Other - Last Name:COCHRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5400 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-3833
Mailing Address - Country:US
Mailing Address - Phone:352-428-7817
Mailing Address - Fax:352-797-2491
Practice Address - Street 1:12900 CORTEZ BLVD STE 102
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-6897
Practice Address - Country:US
Practice Address - Phone:352-596-7660
Practice Address - Fax:352-596-5581
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11015339207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine