Healthcare Provider Details

I. General information

NPI: 1881908986
Provider Name (Legal Business Name): CYNTHIA RENEE HAYS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2010
Last Update Date: 12/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 S JEFFERSON AVE SUITE 118
SAINT LOUIS MO
63118-3930
US

IV. Provider business mailing address

5944 GRAMOND DR
SAINT LOUIS MO
63123-3516
US

V. Phone/Fax

Practice location:
  • Phone: 314-776-7999
  • Fax: 314-772-2257
Mailing address:
  • Phone: 314-303-6710
  • Fax: 314-353-2662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2010026290
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: