Provider Demographics
NPI:1154055408
Name:NOVAK, HAYLEY (PA-C)
Entity type:Individual
Prefix:MRS
First Name:HAYLEY
Middle Name:
Last Name:NOVAK
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:HAYLEY
Other - Middle Name:JOAN
Other - Last Name:HAERTEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:921 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-2918
Mailing Address - Country:US
Mailing Address - Phone:605-323-8997
Mailing Address - Fax:
Practice Address - Street 1:2501 W 22ND ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1305
Practice Address - Country:US
Practice Address - Phone:605-336-3230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1394363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant