Provider Demographics
NPI:1447213988
Name:HAYES, SANDRA K (NP)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:K
Last Name:HAYES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:K
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2829 VIRGINIA AVENUE
Mailing Address - Street 2:
Mailing Address - City:NARROWS
Mailing Address - State:VA
Mailing Address - Zip Code:24124
Mailing Address - Country:US
Mailing Address - Phone:540-726-7960
Mailing Address - Fax:540-726-8012
Practice Address - Street 1:2829 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:NARROWS
Practice Address - State:VA
Practice Address - Zip Code:24124
Practice Address - Country:US
Practice Address - Phone:540-726-7900
Practice Address - Fax:540-726-8012
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024-115865363LF0000X
VA0024115865363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007794983Medicaid
VA007794983Medicaid
VA017924C18Medicare PIN
VAP92151Medicare UPIN
001935C23Medicare PIN