Provider Demographics
NPI:1255059655
Name:GODFREY, HAILEY ELIZABETH (PHARMD)
Entity type:Individual
Prefix:
First Name:HAILEY
Middle Name:ELIZABETH
Last Name:GODFREY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:HAILEY
Other - Middle Name:ELIZABETH
Other - Last Name:STRAHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3225 US HIGHWAY 41 W
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-9495
Mailing Address - Country:US
Mailing Address - Phone:906-226-5015
Mailing Address - Fax:
Practice Address - Street 1:3225 US HIGHWAY 41 W
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-9495
Practice Address - Country:US
Practice Address - Phone:906-226-5015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302414559183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist