Healthcare Provider Details

I. General information

NPI: 1154076503
Provider Name (Legal Business Name): ANDREA HAYES APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2022
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 SE 11TH STREET
ANADARKO OK
73005
US

IV. Provider business mailing address

412 SE 11TH STREET
ANADARKO OK
73005
US

V. Phone/Fax

Practice location:
  • Phone: 405-247-9500
  • Fax: 405-247-9505
Mailing address:
  • Phone: 405-247-9500
  • Fax: 405-247-9505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP144182
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: