Healthcare Provider Details

I. General information

NPI: 1750002804
Provider Name (Legal Business Name): STEPHEN J HAYS MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2022
Last Update Date: 09/07/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3931 LOUISIANA AVE S
ST LOUIS PARK MN
55426-5000
US

IV. Provider business mailing address

5012 MORGAN AVE S
MINNEAPOLIS MN
55419-1024
US

V. Phone/Fax

Practice location:
  • Phone: 952-993-9140
  • Fax:
Mailing address:
  • Phone: 612-987-7899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: