Provider Demographics
NPI:1053803239
Name:SCHANEN, HAYLEY MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:MARIE
Last Name:SCHANEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:MARIE
Other - Last Name:SCHOTTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4005 COMMUNITY CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WI
Mailing Address - Zip Code:54476-4139
Mailing Address - Country:US
Mailing Address - Phone:715-847-2812
Mailing Address - Fax:
Practice Address - Street 1:2200 WESTWOOD DR
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-7806
Practice Address - Country:US
Practice Address - Phone:715-847-2118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant