Healthcare Provider Details

I. General information

NPI: 1063726578
Provider Name (Legal Business Name): TINA MARIE MATTHEWS-HAYES MSN, PMHNP-BC, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2010
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6350 CENTER DR STE 102
NORFOLK VA
23502-4107
US

IV. Provider business mailing address

6350 CENTER DR STE 102
NORFOLK VA
23502-4107
US

V. Phone/Fax

Practice location:
  • Phone: 503-922-2999
  • Fax: 503-922-1920
Mailing address:
  • Phone: 412-638-5490
  • Fax: 503-922-1920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP013074
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10016847
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number0024182838
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN601211
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: