Provider Demographics
NPI:1083946974
Name:HAUBRICH, JOY (RN)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:HAUBRICH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5304 TWO MILE RD
Mailing Address - Street 2:
Mailing Address - City:FRANKSVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53126-9605
Mailing Address - Country:US
Mailing Address - Phone:262-835-9070
Mailing Address - Fax:
Practice Address - Street 1:5304 TWO MILE RD
Practice Address - Street 2:
Practice Address - City:FRANKSVILLE
Practice Address - State:WI
Practice Address - Zip Code:53126-9605
Practice Address - Country:US
Practice Address - Phone:262-835-9070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI168845163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse