Provider Demographics
NPI:1760099592
Name:HAYES, TINA LOUISE
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:LOUISE
Last Name:HAYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62920 CENTERVILLE WARNOCK RD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43718-9632
Mailing Address - Country:US
Mailing Address - Phone:740-686-2646
Mailing Address - Fax:
Practice Address - Street 1:62920 CENTERVILLE WARNOCK RD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:OH
Practice Address - Zip Code:43718-9632
Practice Address - Country:US
Practice Address - Phone:740-686-2646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care