Healthcare Provider Details

I. General information

NPI: 1376238139
Provider Name (Legal Business Name): KALEY HAARBAUER PMHNP-BC, APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2023
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 MOUNT VERNON WAY
MOUNT PLEASANT WI
53406-2767
US

IV. Provider business mailing address

5600 MOUNT VERNON WAY
MOUNT PLEASANT WI
53406-2767
US

V. Phone/Fax

Practice location:
  • Phone: 262-496-1716
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number18495
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number254510
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: