Healthcare Provider Details

I. General information

NPI: 1679210116
Provider Name (Legal Business Name): HALEY JEAN GATT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2022
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11218 HILLMAN
DAVISBURG MI
48350-3508
US

IV. Provider business mailing address

11218 HILLMAN
DAVISBURG MI
48350-3508
US

V. Phone/Fax

Practice location:
  • Phone: 248-930-3154
  • Fax:
Mailing address:
  • Phone: 248-930-3154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4704352663
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: