HALEY LYNN KLOBERDANZ (ARNP, PMHNP-BC) – Registered Nurse, NPI 1104553304

HALEY LYNN KLOBERDANZ (ARNP, PMHNP-BC) is a healthcare provider. based in Austin, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials ARNP, PMHNP-BC. They hold a License No. G175218 (IA). The NPI Number for HALEY LYNN KLOBERDANZ (ARNP, PMHNP-BC) is 1104553304

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
HALEY LYNN KLOBERDANZ (ARNP, PMHNP-BC)
NPI
1104553304
Phone
(512) 472-4357
Address
1430 COLLIER ST
Enumeration Date
7 August 2022
Last Update Date
10 October 2023

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS AT AUSTIN DELL MEDICAL SCHOOL
Secondary Phone
5153687504
Graduation Year
2023 (3 years ago)
PAC ID
6901267988
Group Practice PAC ID
5496168882
Professional Enrollment ID
I20230808000251
Address ID
IA501312953JO5408XSTXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness75
Years active:3State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for HALEY LYNN KLOBERDANZ (ARNP, PMHNP-BC)

  • 1430 COLLIER ST

    AUSTIN, TX 787042911

    Phone: (512) 472-4357

    Fax: (512) 703-1394

    Type: Mailing

  • 6600 E BEN WHITE BLVD

    AUSTIN, TX 787417537

    Phone: (512) 804-3770

    Type: Location

  • 5408 NW 88TH ST STE 140

    JOHNSTON, IA 501312953

    Phone: (515) 368-7504

    Fax: (515) 355-3491

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 122 Open Payments records for all available years, with a total value of $2,212.

Total Amount is formed as General ($2,212) + Research ($0) + Ownership ($0) = $2,212.

Last reported payment date: 2024-12-13 • Largest payer in this snapshot: ABBVIE INC. ($557).

Total Amount

$2,212

General + Research + Ownership

Payments

122

Total payment records

General Amount

$2,212

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-13

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-08-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230808000251INurse PractitionerIATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 78704)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5496168882View full group profile
NameSpecialtyState
Nurse PractitionerIA
Physician AssistantVA
Physician AssistantIA
Physician AssistantIA
Clinical PsychologistIA
Nurse PractitionerTX
Nurse PractitionerIA
Nurse PractitionerIA
Mental Health CounselorIA
Physician AssistantIA

Reviews

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Frequently asked questions

What number should I use to identify HALEY LYNN KLOBERDANZ (ARNP, PMHNP-BC) for billing?
Administrative and clinical systems typically use NPI 1104553304 for HALEY LYNN KLOBERDANZ (ARNP, PMHNP-BC).
Quick check: is HALEY LYNN KLOBERDANZ (ARNP, PMHNP-BC) active?
Public NPPES data shows HALEY LYNN KLOBERDANZ (ARNP, PMHNP-BC) with an active NPI status right now.
How should patients interpret HALEY LYNN KLOBERDANZ (ARNP, PMHNP-BC)'s specialty?
The extract shows Registered Nurse for HALEY LYNN KLOBERDANZ (ARNP, PMHNP-BC). Clinical services aligned with this taxonomy classification.
Can patients visit HALEY LYNN KLOBERDANZ (ARNP, PMHNP-BC) in Austin, Texas?
For routing, start with Austin, Texas for HALEY LYNN KLOBERDANZ (ARNP, PMHNP-BC), then verify phone and hours locally.
Who maintains HALEY LYNN KLOBERDANZ (ARNP, PMHNP-BC)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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