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General NPI Number Information
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NPI Number | 1215683883
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Entity Type | Individual
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Provider Name | DREW HAYES
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Gender | Male
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Dates
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Enumeration Date | 02/23/2022
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Last Update Date | 02/23/2022
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Provider Practice Location Address
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Address Line | 1101 9TH ST N
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City | VIRGINIA
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State | MN
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Zip | 55792-2329
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Country | US
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Telephone | 218-305-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 1502 COACH LIGHT CIR
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City | PROCTOR
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State | MN
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Zip | 55810-2506
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Country | US
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Telephone | 218-209-5236
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9001
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License Number State | MN
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