Provider Demographics
NPI:1477905123
Name:HAYES, RICHARD
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
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 1:3481 MALLORY ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:MI
Mailing Address - Zip Code:48701-9798
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3481 MALLORY ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:MI
Practice Address - Zip Code:48701-9798
Practice Address - Country:US
Practice Address - Phone:989-528-0718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider