Provider Demographics
NPI:1073223004
Name:HAYES, KRISTEN MICHELE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MICHELE
Last Name:HAYES
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4191 INNSLAKE DR STE 211
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-3324
Mailing Address - Country:US
Mailing Address - Phone:804-303-9622
Mailing Address - Fax:804-716-4318
Practice Address - Street 1:4191 INNSLAKE DR STE 211
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-3324
Practice Address - Country:US
Practice Address - Phone:804-303-9622
Practice Address - Fax:804-716-4318
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-30
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024185049363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health