Healthcare Provider Details

I. General information

NPI: 1750201547
Provider Name (Legal Business Name): JEREMIAH QUINN HAYES ACNPC-AG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 REDMOND RD NW
ROME GA
30165-1415
US

IV. Provider business mailing address

43 BROOKE CT SE
ROME GA
30161-3154
US

V. Phone/Fax

Practice location:
  • Phone: 813-333-9108
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN306469
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: