Provider Demographics
NPI:1912644535
Name:KAYE, HAILEY JEAN (PA)
Entity type:Individual
Prefix:
First Name:HAILEY
Middle Name:JEAN
Last Name:KAYE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5312 WILLOWVIEW RD
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53402-2256
Mailing Address - Country:US
Mailing Address - Phone:920-420-2091
Mailing Address - Fax:
Practice Address - Street 1:5312 WILLOWVIEW RD
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53402-2256
Practice Address - Country:US
Practice Address - Phone:920-420-2091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant