Provider Demographics
NPI:1831253392
Name:HAYES, SARA JEAN (FNP)
Entity type:Individual
Prefix:MS
First Name:SARA
Middle Name:JEAN
Last Name:HAYES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 RICHARDS LN
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04032-6712
Mailing Address - Country:US
Mailing Address - Phone:207-778-4553
Mailing Address - Fax:207-778-4257
Practice Address - Street 1:193 FRONT ST
Practice Address - Street 2:SUITE 5
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-5834
Practice Address - Country:US
Practice Address - Phone:207-778-4553
Practice Address - Fax:207-778-4553
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME18544363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME262890099Medicaid
MEHANP0589Medicare ID - Type Unspecified