Provider Demographics
NPI:1598597429
Name:GOGGLEYE, HALEY ANN VIVIAN
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:ANN VIVIAN
Last Name:GOGGLEYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 E LAKE ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1616
Mailing Address - Country:US
Mailing Address - Phone:612-276-1503
Mailing Address - Fax:
Practice Address - Street 1:1001 E LAKE ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1616
Practice Address - Country:US
Practice Address - Phone:612-276-1503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula