Healthcare Provider Details

I. General information

NPI: 1275336844
Provider Name (Legal Business Name): LAUREN KING HAYS AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 03/31/2025
Certification Date: 03/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 8TH AVE
FORT WORTH TX
76110-1812
US

IV. Provider business mailing address

1615 WINTERGREEN CT
HASLET TX
76052-2126
US

V. Phone/Fax

Practice location:
  • Phone: 817-336-5060
  • Fax:
Mailing address:
  • Phone: 214-566-7616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1193826
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: