Provider Demographics
NPI:1134995673
Name:NORMAN-HAUGER, BAYLIE BROOKE
Entity type:Individual
Prefix:
First Name:BAYLIE
Middle Name:BROOKE
Last Name:NORMAN-HAUGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 MOORE AVE
Mailing Address - Street 2:
Mailing Address - City:HOLDENVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74848-4220
Mailing Address - Country:US
Mailing Address - Phone:405-683-1223
Mailing Address - Fax:
Practice Address - Street 1:116 MOORE AVE
Practice Address - Street 2:
Practice Address - City:HOLDENVILLE
Practice Address - State:OK
Practice Address - Zip Code:74848-4220
Practice Address - Country:US
Practice Address - Phone:405-683-1223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program