1447213988 NPI number — MRS. SANDRA K HAYES NP

Table of content: MRS. SANDRA K HAYES NP (NPI 1447213988)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447213988 NPI number — MRS. SANDRA K HAYES NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAYES
Provider First Name:
SANDRA
Provider Middle Name:
K
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SANDERS
Provider Other First Name:
SUSAN
Provider Other Middle Name:
K
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
NP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447213988
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/07/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2829 VIRGINIA AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NARROWS
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24124
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-726-7960
Provider Business Mailing Address Fax Number:
540-726-8012

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2829 VIRGINIA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NARROWS
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-726-7900
Provider Business Practice Location Address Fax Number:
540-726-8012
Provider Enumeration Date:
04/07/2006

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: 363LF0000X , with the licence number:  0024-115865 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: 0024115865 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 007794983 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".