Provider Demographics
NPI:1720483266
Name:HAYES, JASON (APRN-RX, FNP-C)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:HAYES
Suffix:
Gender:M
Credentials:APRN-RX, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3917 WEST RD STE A
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544-2292
Mailing Address - Country:US
Mailing Address - Phone:505-661-8900
Mailing Address - Fax:
Practice Address - Street 1:1908 CALLE MIQUELA
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-5635
Practice Address - Country:US
Practice Address - Phone:505-425-0557
Practice Address - Fax:505-661-8916
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-03463363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily