Basic Information
| Provider Information | |||||||||
| NPI: | 1699353904 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HALEY | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | MARIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | S29W31782 ROBERTS RD | ||||||||
| Address2: | |||||||||
| City: | WAUKESHA | ||||||||
| State: | WI | ||||||||
| PostalCode: | 531889114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4145730603 | ||||||||
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| Practice Location | |||||||||
| Address1: | 19333 W NORTH AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKFIELD | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530454132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2627852000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2021 | ||||||||
| LastUpdateDate: | 03/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WE0003X | 116153-030 | WI | Y | Nursing Service Providers | Registered Nurse | Emergency |
No ID Information.