Provider Demographics
NPI:1427894955
Name:FIALKOWSKI, HAILEY (RN, BSN)
Entity type:Individual
Prefix:
First Name:HAILEY
Middle Name:
Last Name:FIALKOWSKI
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:MRS
Other - First Name:HAILEY
Other - Middle Name:
Other - Last Name:SIMMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:1417 E 46TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-4761
Mailing Address - Country:US
Mailing Address - Phone:918-407-3563
Mailing Address - Fax:
Practice Address - Street 1:1417 E 46TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-4761
Practice Address - Country:US
Practice Address - Phone:918-407-3563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0131269163W00000X, 163WH0200X, 171M00000X, 251E00000X, 372500000X, 372600000X, 3747A0650X, 3747P1801X, 374U00000X, 376J00000X, 251J00000X
OKP083075979172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172A00000XOther Service ProvidersDriver
No251E00000XAgenciesHome Health
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker