Provider Demographics
NPI:1780188995
Name:LORCA, HAYLEI MADISON (APRN)
Entity Type:Individual
Prefix:
First Name:HAYLEI
Middle Name:MADISON
Last Name:LORCA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 E STATE ROAD 44 STE B
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-4030
Mailing Address - Country:US
Mailing Address - Phone:317-743-5980
Mailing Address - Fax:
Practice Address - Street 1:1640 E STATE ROAD 44 STE B
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-4030
Practice Address - Country:US
Practice Address - Phone:317-421-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28229486A363LP0808X
OHAPRN.CNP.023163363LP0808X
IN71008111A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health