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NPI Code Detail

MEDICARE: JUDY LYNN HAYES RN

MEDICARE: JUDY LYNN HAYES RN
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
1163WP0808XPsychiatric/Mental Health Registered NurseRN102765AZ

General Provider Information

NPI Number : 1508848862
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDY LYNN HAYES RN
Provider Business Mailing Address
First Line : 642 DAMERON DR
Second Line :
City : PRESCOTT
State : AZ
Zip : 86301-2411
Country : US
Telephone Number : 928-445-5211
Fax Number : 928-776-8484
Provider Business Practice Location Address
First Line : 642 DAMERON DR
Second Line :
City : PRESCOTT
State : AZ
Zip : 86301-2411
Country : US
Telephone Number : 928-445-5211
Fax Number : 928-776-8484
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2005
Last Update Date : 07/08/2007

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