Provider Demographics
NPI:1417424672
Name:HAYES, KANISHA DANIELLE
Entity Type:Individual
Prefix:
First Name:KANISHA
Middle Name:DANIELLE
Last Name:HAYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16112 NORTH FWY APT 2023
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-5544
Mailing Address - Country:US
Mailing Address - Phone:531-375-9747
Mailing Address - Fax:
Practice Address - Street 1:16112 NORTH FWY APT 2023
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-5544
Practice Address - Country:US
Practice Address - Phone:531-375-9747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376J00000X, 372500000X
TX372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No376J00000XNursing Service Related ProvidersHomemaker
No372600000XNursing Service Related ProvidersAdult Companion