Provider Demographics
NPI:1851055271
Name:HAYES, TRUDY SHANTELLER (TRANSPORTATION)
Entity Type:Individual
Prefix:
First Name:TRUDY
Middle Name:SHANTELLER
Last Name:HAYES
Suffix:
Gender:F
Credentials:TRANSPORTATION
Other - Prefix:
Other - First Name:TRUDY
Other - Middle Name:SHANTELLER
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:TRANSPORTATION
Mailing Address - Street 1:2633 CARONDELET ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-5913
Mailing Address - Country:US
Mailing Address - Phone:504-516-4915
Mailing Address - Fax:
Practice Address - Street 1:2633 CARONDELET ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-5913
Practice Address - Country:US
Practice Address - Phone:504-516-4915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA007861554