Provider Demographics
NPI:1568159002
Name:HAYS, TRACI JO (LPN)
Entity Type:Individual
Prefix:MRS
First Name:TRACI
Middle Name:JO
Last Name:HAYS
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 1:1933 NEWGARDEN RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-9564
Mailing Address - Country:US
Mailing Address - Phone:330-423-5961
Mailing Address - Fax:
Practice Address - Street 1:1933 NEWGARDEN RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-9564
Practice Address - Country:US
Practice Address - Phone:330-423-5961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH178483164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse