Provider Demographics
NPI:1790883775
Name:HAYES, ANNE MARIE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARIE
Last Name:HAYES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3785 RELIABLE PKWY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60686-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5 JOPLIN PL
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25303-2729
Practice Address - Country:US
Practice Address - Phone:304-533-6718
Practice Address - Fax:316-281-3721
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV56168163W00000X
WV71757367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVP00183612OtherRR MEDICARE
KY000000548268OtherANTHEM BLUE CROSS BLUE SHIELD
WV3810001588Medicaid
KY3403677Medicare PIN
KY000000548268OtherANTHEM BLUE CROSS BLUE SHIELD