Healthcare Provider Details

I. General information

NPI: 1396373932
Provider Name (Legal Business Name): HAYLEY STARR PATEL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HAYLEY STARR GIFFORD

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E SUPERIOR ST
DULUTH MN
55802-2207
US

IV. Provider business mailing address

915 E 1ST ST
DULUTH MN
55805-2107
US

V. Phone/Fax

Practice location:
  • Phone: 218-249-5555
  • Fax:
Mailing address:
  • Phone: 218-249-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0284554
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number7702
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: