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General NPI Number Information
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NPI Number | 1962050203
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Entity Type | Individual
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Provider Name | SUZETTE HAYES DNP, MSN, AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/29/2019
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Last Update Date | 12/01/2022
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Provider Practice Location Address
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Address Line | 1707 RUTLAND AVE
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City | BALTIMORE
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State | MD
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Zip | 21213-2466
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Country | US
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Telephone | 202-841-4927
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Fax |
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Provider Business Mailing Address
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Address Line | 12105 CHIP SHOT LN
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City | UPPER MARLBORO
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State | MD
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Zip | 20772-7963
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Country | US
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Telephone | 202-841-4927
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN192573
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License Number State | MD
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