Provider Demographics
NPI:1730845058
Name:KALLAS, HAYLEE E (PA)
Entity type:Individual
Prefix:
First Name:HAYLEE
Middle Name:E
Last Name:KALLAS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:HAYLEE
Other - Middle Name:E
Other - Last Name:KLOEPPEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:70 S CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-1397
Mailing Address - Country:US
Mailing Address - Phone:614-890-6555
Mailing Address - Fax:
Practice Address - Street 1:6785 BOBCAT WAY STE 300
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-1443
Practice Address - Country:US
Practice Address - Phone:614-890-6555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-10
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant