Provider Demographics
NPI:1003472242
Name:STURM, HAILEY E (PA)
Entity type:Individual
Prefix:
First Name:HAILEY
Middle Name:E
Last Name:STURM
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:HAILEY
Other - Middle Name:
Other - Last Name:RIGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 632111
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-2111
Mailing Address - Country:US
Mailing Address - Phone:812-450-6879
Mailing Address - Fax:812-858-4586
Practice Address - Street 1:4055 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-7451
Practice Address - Country:US
Practice Address - Phone:812-858-3051
Practice Address - Fax:812-858-3060
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10002747A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant