Provider Demographics
NPI:1689047086
Name:HAYE, KIMBERLI JACQUELINE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:KIMBERLI
Middle Name:JACQUELINE
Last Name:HAYE
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 1:5 FORBES RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-7130
Mailing Address - Country:US
Mailing Address - Phone:845-617-1858
Mailing Address - Fax:845-290-6358
Practice Address - Street 1:5 FORBES RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-7130
Practice Address - Country:US
Practice Address - Phone:845-617-1858
Practice Address - Fax:845-290-6358
Is Sole Proprietor?:No
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY321847-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse