Provider Demographics
NPI:1629556873
Name:HAYE, ANDREA JOY
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:JOY
Last Name:HAYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 STONE RIVER LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-8867
Mailing Address - Country:US
Mailing Address - Phone:281-788-1964
Mailing Address - Fax:
Practice Address - Street 1:2911 STONE RIVER LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-8867
Practice Address - Country:US
Practice Address - Phone:281-788-1964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX179703164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse