Provider Demographics
NPI:1417542978
Name:HANES, TRUDI LYNN (CNA)
Entity Type:Individual
Prefix:
First Name:TRUDI
Middle Name:LYNN
Last Name:HANES
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 PARADISE VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:PA
Mailing Address - Zip Code:15857-4144
Mailing Address - Country:US
Mailing Address - Phone:814-335-9685
Mailing Address - Fax:
Practice Address - Street 1:516 PARADISE VALLEY RD
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857-4144
Practice Address - Country:US
Practice Address - Phone:814-335-9685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-06
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide