Provider Demographics
NPI:1679580278
Name:HAYES, HELEN BERNICE (FNP-BC, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:BERNICE
Last Name:HAYES
Suffix:
Gender:F
Credentials:FNP-BC, PMHNP-BC
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:BERNICE
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP, PMHNP
Mailing Address - Street 1:PO BOX 79254
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28271-7061
Mailing Address - Country:US
Mailing Address - Phone:704-234-2594
Mailing Address - Fax:855-313-5068
Practice Address - Street 1:115 UNIONVILLE INDIAN TRAIL RD W
Practice Address - Street 2:SUITE A-1
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-5583
Practice Address - Country:US
Practice Address - Phone:704-234-2594
Practice Address - Fax:855-313-5068
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201021363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7005792Medicaid
NC7005792Medicaid