Healthcare Provider Details

I. General information

NPI: 1457970568
Provider Name (Legal Business Name): ANDREA HAYES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 AIRPORT BLVD STE B123
MOBILE AL
36608-6775
US

IV. Provider business mailing address

PO BOX 746450
ATLANTA GA
30374-6450
US

V. Phone/Fax

Practice location:
  • Phone: 251-300-5140
  • Fax: 251-300-2249
Mailing address:
  • Phone: 251-434-3626
  • Fax: 251-445-2464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.1829
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: