MEDICARE: HAYLEY D HERTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347C00000X	Private Vehicle
2	376J00000X	Homemaker

General Provider Information

NPI Number	:	1134065923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAYLEY D HERTA

Provider Business Mailing Address
First Line	:	449 E MAIN ST
Second Line	:
City	:	NEWARK
State	:	OH
Zip	:	43055-6559
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	449 E MAIN ST
Second Line	:
City	:	NEWARK
State	:	OH
Zip	:	43055-6559
Country	:	US
Telephone Number	:	740-405-3794
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2026
Last Update Date	:	04/25/2026

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Directions to “ HAYLEY D HERTA ” Practice Location

Language	Start Address	Practice Location

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