Provider Demographics
NPI:1669048799
Name:HAYES, MORIAH CHRISTINE (APRN-CNP)
Entity type:Individual
Prefix:
First Name:MORIAH
Middle Name:CHRISTINE
Last Name:HAYES
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:MORIAH
Other - Middle Name:CHRISTINE
Other - Last Name:PHILMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:87 REED RD
Mailing Address - Street 2:
Mailing Address - City:BOONEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72927-4816
Mailing Address - Country:US
Mailing Address - Phone:479-849-5000
Mailing Address - Fax:
Practice Address - Street 1:6724 POSSUM HOLLOW RD
Practice Address - Street 2:
Practice Address - City:BOONEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72927-7806
Practice Address - Country:US
Practice Address - Phone:479-849-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-30
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR215446363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty