Provider Demographics
NPI:1235415332
Name:WEBDELL, HAYLEY ELIZABETH
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:ELIZABETH
Last Name:WEBDELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:ELIZABETH
Other - Last Name:AUGENSTINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12392 RUSH ST
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-7990
Mailing Address - Country:US
Mailing Address - Phone:219-902-9371
Mailing Address - Fax:
Practice Address - Street 1:101 W US HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-7337
Practice Address - Country:US
Practice Address - Phone:219-879-9650
Practice Address - Fax:219-879-9687
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26020770A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist