Provider Demographics
NPI:1629049465
Name:HAYES, KATHLEEN M (APRN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:HAYES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 WAITE ST
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06517-2530
Mailing Address - Country:US
Mailing Address - Phone:203-287-8836
Mailing Address - Fax:
Practice Address - Street 1:300 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-3100
Practice Address - Country:US
Practice Address - Phone:860-297-2018
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000106363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily