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General NPI Number Information
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NPI Number | 1477192151
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Entity Type | Individual
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Provider Name | DEBRA SUSAN HAYES FNP
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Gender | Female
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Dates
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Enumeration Date | 12/30/2019
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Last Update Date | 04/11/2024
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Provider Practice Location Address
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Address Line | 1399 S SALINE 4TH ST
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City | CENTERPOINT
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State | IN
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Zip | 47840-8217
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Country | US
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Telephone | 812-605-4887
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Fax |
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Provider Business Mailing Address
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Address Line | 1399 S SALINE 4TH ST
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City | CENTERPOINT
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State | IN
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Zip | 47840-8217
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 71010040A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 28195033A
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License Number State | IN
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