Provider Demographics
NPI:1932524220
Name:HAYES, JOAN MERRIMAN RANKIN (RN)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:MERRIMAN RANKIN
Last Name:HAYES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3115 SW NEBRASKA ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-1058
Mailing Address - Country:US
Mailing Address - Phone:503-812-4948
Mailing Address - Fax:
Practice Address - Street 1:3115 SW NEBRASKA ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-1058
Practice Address - Country:US
Practice Address - Phone:503-812-4948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201142398 RN163W00000X
OR201142398RN163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163W00000XNursing Service ProvidersRegistered Nurse