Provider Demographics
NPI:1609905488
Name:HAYES, JENNIE LYNN (MSPT)
Entity Type:Individual
Prefix:
First Name:JENNIE
Middle Name:LYNN
Last Name:HAYES
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3422 BIRKENHEAD CIR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-4257
Mailing Address - Country:US
Mailing Address - Phone:859-215-0157
Mailing Address - Fax:
Practice Address - Street 1:465 SPRINGHILL DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1233
Practice Address - Country:US
Practice Address - Phone:859-278-0549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY003518225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist