Healthcare Provider Details
I. General information
NPI: 1003812918
Provider Name (Legal Business Name): KAREN S. HAYES N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/24/2005
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1870 BAGNELL DAM BLVD
LAKE OZARK MO
65049-8658
US
IV. Provider business mailing address
PO BOX 1500
OSAGE BEACH MO
65065-1500
US
V. Phone/Fax
- Phone: 573-365-2318
- Fax: 573-365-3009
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 44778 |
| License Number State | KS |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 2013010843 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: