Provider Demographics
NPI:1467023481
Name:BIBA, HALEY MARIE (RN)
Entity Type:Individual
Prefix:MISS
First Name:HALEY
Middle Name:MARIE
Last Name:BIBA
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 1:5416 E LEGRAND ST
Mailing Address - Street 2:
Mailing Address - City:BOSCOBEL
Mailing Address - State:WI
Mailing Address - Zip Code:53805-9137
Mailing Address - Country:US
Mailing Address - Phone:608-485-1763
Mailing Address - Fax:
Practice Address - Street 1:5416 E LEGRAND ST
Practice Address - Street 2:
Practice Address - City:BOSCOBEL
Practice Address - State:WI
Practice Address - Zip Code:53805-9137
Practice Address - Country:US
Practice Address - Phone:608-485-1763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI248452-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse