Provider Demographics
NPI:1629334107
Name:HAYS, KRISTA L (LM)
Entity Type:Individual
Prefix:MS
First Name:KRISTA
Middle Name:L
Last Name:HAYS
Suffix:
Gender:F
Credentials:LM
Other - Prefix:MS
Other - First Name:KRISTA
Other - Middle Name:L
Other - Last Name:NICHOLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:712 16TH AVE S
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-4730
Mailing Address - Country:US
Mailing Address - Phone:208-467-1230
Mailing Address - Fax:208-475-7101
Practice Address - Street 1:712 16TH AVE S
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-4730
Practice Address - Country:US
Practice Address - Phone:208-467-1230
Practice Address - Fax:208-475-7101
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDMID-43176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife