Provider Demographics
NPI:1538459607
Name:HAYES, KEISHA LAMEKA (LPN)
Entity Type:Individual
Prefix:MISS
First Name:KEISHA
Middle Name:LAMEKA
Last Name:HAYES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 N 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:SC
Mailing Address - Zip Code:29536-2415
Mailing Address - Country:US
Mailing Address - Phone:843-774-5390
Mailing Address - Fax:
Practice Address - Street 1:611 N 5TH AVE
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:SC
Practice Address - Zip Code:29536-2415
Practice Address - Country:US
Practice Address - Phone:843-774-5390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCP42932164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse