Provider Demographics
NPI:1770288011
Name:HUSSKE, HAYLEY R
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:R
Last Name:HUSSKE
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:PO BOX 741292
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80006-1292
Mailing Address - Country:US
Mailing Address - Phone:563-271-2754
Mailing Address - Fax:
Practice Address - Street 1:7751 ZENOBIA CT
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80030-4659
Practice Address - Country:US
Practice Address - Phone:303-412-9121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14286225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant