Provider Demographics
NPI:1932177490
Name:HAYES, VICKI L (ARNP-C)
Entity Type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:L
Last Name:HAYES
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:MS
Other - First Name:VICKI
Other - Middle Name:L
Other - Last Name:VANNOY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-0258
Mailing Address - Fax:239-343-0973
Practice Address - Street 1:9981 S HEALTHPARK DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3618
Practice Address - Country:US
Practice Address - Phone:239-343-6860
Practice Address - Fax:239-985-3528
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2596362363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003312000Medicaid
FLP92318Medicare UPIN