Provider Demographics
NPI:1578163184
Name:STROMBACH, HALEIGH MARIE (RN)
Entity Type:Individual
Prefix:
First Name:HALEIGH
Middle Name:MARIE
Last Name:STROMBACH
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 1:162 CUSTER CT
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-1243
Mailing Address - Country:US
Mailing Address - Phone:920-664-1632
Mailing Address - Fax:
Practice Address - Street 1:162 CUSTER CT
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-1243
Practice Address - Country:US
Practice Address - Phone:920-664-1632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-01
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI243826-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse