Provider Demographics
NPI:1902824246
Name:HAYES, SANDRA LEE (ARNP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LEE
Last Name:HAYES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 N LORRAINE ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67501-5670
Mailing Address - Country:US
Mailing Address - Phone:620-663-7595
Mailing Address - Fax:620-728-2031
Practice Address - Street 1:1600 N LORRAINE ST
Practice Address - Street 2:SUITE 202
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501-5670
Practice Address - Country:US
Practice Address - Phone:620-663-7595
Practice Address - Fax:620-728-2031
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS74821363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS161082Medicaid
KS161082Medicaid