Healthcare Provider Details

I. General information

NPI: 1831907724
Provider Name (Legal Business Name): CHYNNA A HAYES CPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2024
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 OAK INDUSTRIAL DR NE # 1004
GRAND RAPIDS MI
49505-6008
US

IV. Provider business mailing address

1840 OAK INDUSTRIAL DR NE # 1004
GRAND RAPIDS MI
49505-6008
US

V. Phone/Fax

Practice location:
  • Phone: 616-490-5681
  • Fax:
Mailing address:
  • Phone: 616-490-5681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberN3W5Y6H7
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: