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NPI Code Detail

MEDICARE: HALEY DECERO NP

MEDICARE: HALEY DECERO NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner209.022199IL
2363LF0000XFamily Nurse Practitioner10983-33WI

General Provider Information

NPI Number : 1609478908
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALEY DECERO NP
Provider Business Mailing Address
First Line : 311 N DIVISION ST
Second Line :
City : WAUNAKEE
State : WI
Zip : 53597-2016
Country : US
Telephone Number : 708-222-7536
Fax Number :
Provider Business Practice Location Address
First Line : 5401 QUARRY PARK RD
Second Line :
City : MADISON
State : WI
Zip : 53718-7901
Country : US
Telephone Number : 844-767-3769
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2020
Last Update Date : 08/26/2025

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