Provider Demographics
NPI:1942642236
Name:HAYES, BRIDGET COLLEEN (LPN)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:COLLEEN
Last Name:HAYES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5597 BLUEBELL RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43732-9760
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5597 BLUEBELL RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:OH
Practice Address - Zip Code:43732-9760
Practice Address - Country:US
Practice Address - Phone:740-255-3096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH149855164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse