Hayley Brooke Fine, RN

Primary specialty

Critical Care Medicine Registered NurseTaxonomy code 163WC0200X

License

184043 Issued in WI

Practice address

1105 North Church Street 103
Elkhorn, WI 53121

Phone

(262) 484-7026

NPI assigned

Jan 31, 2021

Last updated

Jan 31, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612051200000",
    "number": "1568053791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 NORTH CHURCH STREET 103",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "53121",
            "telephone_number": "262-484-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 NORTH CHURCH STREET 103",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "53121",
            "telephone_number": "262-484-7026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINE",
        "first_name": "HAYLEY",
        "middle_name": "BROOKE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-31",
        "last_updated": "2021-01-31",
        "certification_date": "2021-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "WI",
            "license": "184043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Elkhorn",
            "affiliation": "N",
            "endpointDescription": "Home",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Home",
            "address_1": "1105 North Church Street 103",
            "city": "Elkhorn",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Critical Care Medicine Registered Nurse in Elkhorn, WI
• Providers in Elkhorn, WI by specialty
• Critical Care Medicine Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.