Provider Demographics
NPI:1033500756
Name:HAYES, TRACY (RN, BSN)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 MARTIN LUTHER KING RD
Mailing Address - Street 2:
Mailing Address - City:MARKSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71351-4970
Mailing Address - Country:US
Mailing Address - Phone:318-729-5781
Mailing Address - Fax:
Practice Address - Street 1:221 MARTIN LUTHER KING RD
Practice Address - Street 2:
Practice Address - City:MARKSVILLE
Practice Address - State:LA
Practice Address - Zip Code:71351-4970
Practice Address - Country:US
Practice Address - Phone:318-729-5781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
LA305R00000X, 372600000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No253Z00000XAgenciesIn Home Supportive Care
No305R00000XManaged Care OrganizationsPreferred Provider Organization
No385H00000XRespite Care FacilityRespite Care