Provider Demographics
NPI:1821806449
Name:GOLDHARDT, HAYLEE (RN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:HAYLEE
Middle Name:
Last Name:GOLDHARDT
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 N GRAY FOX CIR
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-8009
Mailing Address - Country:US
Mailing Address - Phone:435-881-3877
Mailing Address - Fax:
Practice Address - Street 1:56 N GRAY FOX CIR
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-8009
Practice Address - Country:US
Practice Address - Phone:435-881-3877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-28
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTL-166169163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant