Provider Demographics
NPI:1639441603
Name:HAYES, KIYOMI YOLANDA (LPN)
Entity Type:Individual
Prefix:MISS
First Name:KIYOMI
Middle Name:YOLANDA
Last Name:HAYES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 HENRIETTA ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-1511
Mailing Address - Country:US
Mailing Address - Phone:585-563-6136
Mailing Address - Fax:
Practice Address - Street 1:215 HENRIETTA ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-1511
Practice Address - Country:US
Practice Address - Phone:585-563-6136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307342164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse