Healthcare Provider Details

I. General information

NPI: 1588150510
Provider Name (Legal Business Name): VANESSA LEVET HAYES CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2018
Last Update Date: 07/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 MESA VALLEYWAY APT1507
LITHIASPRINGS GA
30122
US

IV. Provider business mailing address

PO BOX 1872
LITHIA SPRINGS GA
30122-1174
US

V. Phone/Fax

Practice location:
  • Phone: 770-873-9176
  • Fax: 770-485-7868
Mailing address:
  • Phone: 770-873-9176
  • Fax: 770-485-7868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License NumberCN0030022709
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License NumberCN0030022709
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License NumberCN0030022709
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License NumberCN0030022709
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberCN0030022709
License Number StateGA
# 6
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberCN0030022709
License Number StateGA
# 7
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberCN0030022709
License Number StateGA
# 8
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License NumberCN0030022709
License Number StateGA
# 9
Primary TaxonomyN
Taxonomy Code2278H0200X
TaxonomyHome Health Certified Respiratory Therapist
License NumberCN0030022709
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: