Provider Demographics
NPI:1356066294
Name:JUREK, HAYLEY (MSN, NP)
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:
Last Name:JUREK
Suffix:
Gender:F
Credentials:MSN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9827 BERWICK PL
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-4309
Mailing Address - Country:US
Mailing Address - Phone:314-606-7203
Mailing Address - Fax:
Practice Address - Street 1:8000 MARYLAND AVE STE 760
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105-3752
Practice Address - Country:US
Practice Address - Phone:314-474-0114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO104390979363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner