MEDICARE: KELSEY RENEA HAYES FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	95038972	CA

General Provider Information

NPI Number	:	1366398026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY RENEA HAYES FNP-C

Provider Business Mailing Address
First Line	:	310 DEL SOL DR APT 363
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-2968
Country	:	US
Telephone Number	:	540-735-5940
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 WASHINGTON ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-2289
Country	:	US
Telephone Number	:	619-260-8300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/12/2026

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