Healthcare Provider Details

I. General information

NPI: 1831253392
Provider Name (Legal Business Name): SARA JEAN HAYES FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

193 FRONT ST SUITE 5
FARMINGTON ME
04938-5834
US

IV. Provider business mailing address

53 RICHARDS LN
FREEPORT ME
04032-6712
US

V. Phone/Fax

Practice location:
  • Phone: 207-778-4553
  • Fax: 207-778-4553
Mailing address:
  • Phone: 207-778-4553
  • Fax: 207-778-4257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number18544
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: