Provider Demographics
NPI:1932436912
Name:HAYHURST, LUCY A
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:A
Last Name:HAYHURST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 WINDING CREEK CIR APT J
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-1560
Mailing Address - Country:US
Mailing Address - Phone:919-491-2004
Mailing Address - Fax:
Practice Address - Street 1:11 WINDING CREEK CIR APT J
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-1560
Practice Address - Country:US
Practice Address - Phone:919-491-2004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003447133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered