Healthcare Provider Details

I. General information

NPI: 1609858109
Provider Name (Legal Business Name): BETTY G HAYHURST MSN, APRN, BC (FNP)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 10/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 HIGHWAY 2
CORINTH MS
38834-7954
US

IV. Provider business mailing address

PO BOX 8023
CORINTH MS
38834-8023
US

V. Phone/Fax

Practice location:
  • Phone: 662-286-5055
  • Fax: 662-286-9700
Mailing address:
  • Phone: 662-286-5055
  • Fax: 662-286-9700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR560634
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: