Healthcare Provider Details

I. General information

NPI: 1427894955
Provider Name (Legal Business Name): HAILEY FIALKOWSKI RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HAILEY SIMMS RN, BSN

II. Dates (important events)

Enumeration Date: 07/03/2024
Last Update Date: 07/03/2024
Certification Date: 07/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 E 46TH ST
TULSA OK
74105-4761
US

IV. Provider business mailing address

1417 E 46TH ST
TULSA OK
74105-4761
US

V. Phone/Fax

Practice location:
  • Phone: 918-407-3563
  • Fax:
Mailing address:
  • Phone: 918-407-3563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR0131269
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberR0131269
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberR0131269
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License NumberP083075979
License Number StateOK
# 5
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberR0131269
License Number StateOK
# 6
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License NumberR0131269
License Number StateOK
# 7
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License NumberR0131269
License Number StateOK
# 8
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License NumberR0131269
License Number StateOK
# 9
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberR0131269
License Number StateOK
# 10
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberR0131269
License Number StateOK
# 11
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License NumberR0131269
License Number StateOK
# 12
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberR0131269
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: