Healthcare Provider Details

I. General information

NPI: 1700145018
Provider Name (Legal Business Name): CAROL ELIZABETH HAYES CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2012
Last Update Date: 05/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST NE STE 1275
ATLANTA GA
30308-2208
US

IV. Provider business mailing address

550 PEACHTREE ST NE STE 1275
ATLANTA GA
30308-2208
US

V. Phone/Fax

Practice location:
  • Phone: 404-872-3121
  • Fax: 404-872-3119
Mailing address:
  • Phone: 404-872-3121
  • Fax: 404-872-3119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN072974
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: