Healthcare Provider Details

I. General information

NPI: 1710939095
Provider Name (Legal Business Name): TANYA N HAYES ACNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TANYA N MORTON RN

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 08/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 E LAMAR ALEXANDER PKWY
MARYVILLE TN
37804-5316
US

IV. Provider business mailing address

PO BOX 5777
MARYVILLE TN
37802-5777
US

V. Phone/Fax

Practice location:
  • Phone: 865-273-8300
  • Fax: 865-246-2106
Mailing address:
  • Phone: 865-246-2104
  • Fax: 865-246-2106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number7637
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: