Provider Demographics
NPI:1689334666
Name:HAYES, HOLLAND (BSN, RN)
Entity Type:Individual
Prefix:
First Name:HOLLAND
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9925 W 67TH ST
Mailing Address - Street 2:
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66203-3621
Mailing Address - Country:US
Mailing Address - Phone:913-206-5234
Mailing Address - Fax:
Practice Address - Street 1:9925 W 67TH ST
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66203-3621
Practice Address - Country:US
Practice Address - Phone:913-206-5234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-18
Last Update Date:2021-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS139229163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse