Provider Demographics
NPI:1710459714
Name:STUMNE, HAYLEY LYNN (DC)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:LYNN
Last Name:STUMNE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 RYANS WAY
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:MN
Mailing Address - Zip Code:55313-4527
Mailing Address - Country:US
Mailing Address - Phone:763-600-8355
Mailing Address - Fax:763-201-5848
Practice Address - Street 1:13352 ABERDEEN ST NE STE A
Practice Address - Street 2:
Practice Address - City:HAM LAKE
Practice Address - State:MN
Practice Address - Zip Code:55304-6877
Practice Address - Country:US
Practice Address - Phone:763-786-5585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6565111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor