Provider Demographics
NPI:1659611416
Name:HAYES, DANIELLE RENEE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:RENEE
Last Name:HAYES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:DANIELLE
Other - Middle Name:R
Other - Last Name:TUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3232 N NORTHHILLS BLVD
Mailing Address - Street 2:HIGHLANDS ONCOLOGY GROUP
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4005
Mailing Address - Country:US
Mailing Address - Phone:479-587-1700
Mailing Address - Fax:479-587-1366
Practice Address - Street 1:808 S 52ND ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8602
Practice Address - Country:US
Practice Address - Phone:479-443-4500
Practice Address - Fax:479-443-4502
Is Sole Proprietor?:No
Enumeration Date:2013-02-15
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPA-518363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR199679795Medicaid
OK200506480AMedicaid