Provider Demographics
NPI:1831467943
Name:HAYES, MICHAEL (STNA)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:HAYES
Suffix:
Gender:M
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 E 117TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44108-2372
Mailing Address - Country:US
Mailing Address - Phone:216-396-5539
Mailing Address - Fax:
Practice Address - Street 1:715 E 117TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108-2372
Practice Address - Country:US
Practice Address - Phone:216-396-5539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
401302210911376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide