Provider Demographics
NPI:1063300978
Name:LANE, HAYLEY NICOLE
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:NICOLE
Last Name:LANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:
Other - Last Name:BERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:244 PORTER DR
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45322-2452
Mailing Address - Country:US
Mailing Address - Phone:937-522-5729
Mailing Address - Fax:
Practice Address - Street 1:244 PORTER DR
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-2452
Practice Address - Country:US
Practice Address - Phone:937-522-5729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator