1164248753 NPI number — KATHERINE HUMMEL HAYES LAPC

Table of content: KATHERINE HUMMEL HAYES LAPC (NPI 1164248753)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164248753 NPI number — KATHERINE HUMMEL HAYES LAPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAYES
Provider First Name:
KATHERINE
Provider Middle Name:
HUMMEL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LAPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HAYES
Provider Other First Name:
KATIE
Provider Other Middle Name:
HUMMEL
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LAPC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1164248753
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/27/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
98 JACQUELYN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAWSONVILLE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30534-3644
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-444-8818
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 NORTHSIDE FORSYTH DR STE 460
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CUMMING
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30041-8483
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-444-8818
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/27/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  APC010006 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)