Haley C Maxwell, PA
Physician Assistant in Bradenton, FL. Individual provider (NPI-1).
NPI number1639769847
StatusActive
Last updated in NPPESMay 20, 2022
Details
- NPI
- 1639769847
- Entity type
- Individual (NPI-1)
- Name
- Haley C Maxwell
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 21, 2021
- Certification date
- Jan 21, 2021
- Last updated
- May 20, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA9113981 | FL | Yes |
| 101Y00000X | Counselor | PA9113981 | FL |
Practice location
2902 59th St W Ste CBradenton, FL 34209-7021
Phone 941-877-7000 · Fax 941-242-1440
Mailing address
2902 59th St W Ste CBradenton, FL 34209-7021
Phone 941-877-7000 · Fax 941-242-1440
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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