Provider Demographics
NPI:1356881015
Name:HANSON, HAYLI
Entity type:Individual
Prefix:
First Name:HAYLI
Middle Name:
Last Name:HANSON
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 1:26 MAPLE CIR
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45786-5321
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26 MAPLE CIR
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:OH
Practice Address - Zip Code:45786-5321
Practice Address - Country:US
Practice Address - Phone:740-336-4296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide