Provider Demographics
NPI:1598772352
Name:HAYES, RITA M (FNP)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:M
Last Name:HAYES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 N 1000 W
Mailing Address - Street 2:
Mailing Address - City:LINTON
Mailing Address - State:IN
Mailing Address - Zip Code:47441-5013
Mailing Address - Country:US
Mailing Address - Phone:812-699-4153
Mailing Address - Fax:
Practice Address - Street 1:102 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47471
Practice Address - Country:US
Practice Address - Phone:812-875-2000
Practice Address - Fax:812-875-2742
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001810A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN153837Medicare Oscar/Certification