Healthcare Provider Details

I. General information

NPI: 1629703012
Provider Name (Legal Business Name): JENNY HAYES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 07/19/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9850 S MARYLAND PKWY STE 19
LAS VEGAS NV
89183-7147
US

IV. Provider business mailing address

10122 DRIFTWOOD ESTATE ST
LAS VEGAS NV
89141-8789
US

V. Phone/Fax

Practice location:
  • Phone: 702-323-6386
  • Fax:
Mailing address:
  • Phone: 731-217-9048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN98236
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: