Provider Demographics
NPI:1629216833
Name:HAYES, LINDA (FNP--BC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:FNP--BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:2660 REIDVILLE RD UNIT 1
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-3512
Practice Address - Country:US
Practice Address - Phone:864-560-6969
Practice Address - Fax:864-560-9636
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-26
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCF2593363LF0000X
SC2593363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAA46207628OtherMEDICARE PIN
SCNP4665Medicaid
SCAA46206067OtherMEDICARE PIN
SCAA462066121OtherMEDICARE PIN
SCAA46205019OtherMEDICARE PIN