Healthcare Provider Details

I. General information

NPI: 1871383208
Provider Name (Legal Business Name): HALLEY CLEWS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 10TH ST SE
CEDAR RAPIDS IA
52403-1251
US

IV. Provider business mailing address

3629 5TH ST
TODDVILLE IA
52341-9655
US

V. Phone/Fax

Practice location:
  • Phone: 319-398-6011
  • Fax:
Mailing address:
  • Phone: 319-550-8821
  • Fax: 319-550-8821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number156895
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: