Provider Demographics
NPI:1528456951
Name:VERKUILEN, HALEY JOY (RN, BSN)
Entity type:Individual
Prefix:MISS
First Name:HALEY
Middle Name:JOY
Last Name:VERKUILEN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 W CALUMET ST APT 5
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-4957
Mailing Address - Country:US
Mailing Address - Phone:920-851-6483
Mailing Address - Fax:
Practice Address - Street 1:219 W CALUMET ST APT 5
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-4957
Practice Address - Country:US
Practice Address - Phone:920-851-6483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital