Healthcare Provider Details

I. General information

NPI: 1033114921
Provider Name (Legal Business Name): JOANNE B HAYES FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 10/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 LYME ROAD KENDAL AT HANOVER
HANOVER NH
03755
US

IV. Provider business mailing address

80 LYME ROAD KENDAL AT HANOVER
HANOVER NH
03755
US

V. Phone/Fax

Practice location:
  • Phone: 603-643-8900
  • Fax:
Mailing address:
  • Phone: 603-643-8900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number101-0029454
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number052157-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: