Provider Demographics
NPI:1235921230
Name:BERBERICK, HALEY JEAN (LPN)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:JEAN
Last Name:BERBERICK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:JEAN
Other - Last Name:SKIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 PARKVIEW PL
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:OH
Mailing Address - Zip Code:44811-9057
Mailing Address - Country:US
Mailing Address - Phone:419-217-6317
Mailing Address - Fax:
Practice Address - Street 1:116 N PORT LN
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:OH
Practice Address - Zip Code:44839-2339
Practice Address - Country:US
Practice Address - Phone:419-217-6317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.154449.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse