Provider Demographics
NPI: | 1477532679 |
---|---|
Name: | HAYMAN, MARGARET MARY DAMIA (CFNP) |
Entity Type: | Individual |
Prefix: | |
First Name: | MARGARET MARY |
Middle Name: | DAMIA |
Last Name: | HAYMAN |
Suffix: | |
Gender: | F |
Credentials: | CFNP |
Other - Prefix: | |
Other - First Name: | MARGARET MARY |
Other - Middle Name: | DAMIA |
Other - Last Name: | BALL |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | RN |
Mailing Address - Street 1: | PO BOX 188 |
Mailing Address - Street 2: | |
Mailing Address - City: | CHILLICOTHE |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 45601-0188 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 740-773-4366 |
Mailing Address - Fax: | 740-773-4426 |
Practice Address - Street 1: | 41865 POMEROY PIKE |
Practice Address - Street 2: | |
Practice Address - City: | POMEROY |
Practice Address - State: | OH |
Practice Address - Zip Code: | 45769-9473 |
Practice Address - Country: | US |
Practice Address - Phone: | 740-992-0540 |
Practice Address - Fax: | 740-773-4018 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2006-01-16 |
Last Update Date: | 2022-12-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
WV | APRN52171NP | 363LF0000X |
OH | NP08312 | 363LF0000X |
OH | APRN.CNP.08312 | 363LF0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
WV | 3810025572 | Medicaid | |
WV | 3810025572 | Medicaid |