Healthcare Provider Details

I. General information

NPI: 1518758986
Provider Name (Legal Business Name): MRS. KATHLEEN DANE HAYES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2025
Last Update Date: 05/15/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E CHEVES STREET CVICU
FLORENCE SC
29506
US

IV. Provider business mailing address

3143 HAVEN STRAITS RD
FLORENCE SC
29505-6667
US

V. Phone/Fax

Practice location:
  • Phone: 843-777-2000
  • Fax:
Mailing address:
  • Phone: 929-403-7731
  • Fax: 929-403-7731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number254410
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: