Provider Demographics
NPI:1689330441
Name:JURELLER, HAYLEY PLUMB (PA-C)
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:PLUMB
Last Name:JURELLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:PLUMB
Other - Last Name:ROOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 1473
Mailing Address - Street 2:
Mailing Address - City:EAST ORLEANS
Mailing Address - State:MA
Mailing Address - Zip Code:02643-1473
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:35 WILKENS LN
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:774-470-5399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-16
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA61256879363A00000X
363A00000X
MAPA100076363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1689330441Medicaid