Individual provider Active NPI

Hailey Trimborn

  • Registered Nurse
  • Watertown, WI
National Provider Identifier
1629442637
Registry record updated Nov 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
179143 Issued in WI
Practice address
N8965 Willow Rd
Watertown, WI 53094-9143
Phone
(920) 650-6211
NPI assigned
Nov 15, 2015
Last updated
Nov 15, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 179143 WI Primary

Addresses

Primary practice location

N8965 Willow Rd
Watertown, WI 53094-9143

Mailing address

N8965 Willow Rd
Watertown, WI 53094-9143
Phone (920) 650-6211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
179143WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1447545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447545600000",
    "number": "1629442637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N8965 WILLOW RD",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530949143",
            "telephone_number": "920-650-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N8965 WILLOW RD",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530949143",
            "telephone_number": "920-650-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIMBORN",
        "first_name": "HAILEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-15",
        "last_updated": "2015-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "179143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2015; 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.