Provider Demographics
NPI:1699181388
Name:SIRJORD, HAYLEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:HAYLEE
Middle Name:
Last Name:SIRJORD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:HAYLEE
Other - Middle Name:
Other - Last Name:PREABT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:40520 COUNTY HIGHWAY 34
Mailing Address - Street 2:
Mailing Address - City:OGEMA
Mailing Address - State:MN
Mailing Address - Zip Code:56569-9612
Mailing Address - Country:US
Mailing Address - Phone:218-983-4300
Mailing Address - Fax:218-983-6384
Practice Address - Street 1:40520 COUNTY HIGHWAY 34
Practice Address - Street 2:
Practice Address - City:OGEMA
Practice Address - State:MN
Practice Address - Zip Code:56569-9612
Practice Address - Country:US
Practice Address - Phone:218-983-4300
Practice Address - Fax:218-983-6384
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRPH5690183500000X
MN121739183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist