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Individual

OLIVIA HAESSLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-5600
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
17523
WI
363LW0102X
Women's Health Nurse Practitioner
35784
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100390274
WI
Enumeration date
02/12/2024
Last updated
01/28/2026
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