Healthcare Provider Details

I. General information

NPI: 1346464377
Provider Name (Legal Business Name): CHRISTINE HYLAND HAYES R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10146 LEDGE RD
BRUSSELS WI
54204-9742
US

IV. Provider business mailing address

10146 LEDGE RD
BRUSSELS WI
54204-9742
US

V. Phone/Fax

Practice location:
  • Phone: 920-825-1375
  • Fax:
Mailing address:
  • Phone: 920-825-1375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number84228-030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: