Provider Demographics
NPI:1932578820
Name:HAYES, AMANDA LYN (WHNP)
Entity Type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:LYN
Last Name:HAYES
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2600 KINGS HWY
Mailing Address - Street 2:#420
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103-3950
Mailing Address - Country:US
Mailing Address - Phone:318-212-8727
Mailing Address - Fax:318-212-8771
Practice Address - Street 1:215 N FRESNO ST STE 490
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2363
Practice Address - Country:US
Practice Address - Phone:559-459-5102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08434363LW0102X
CA95292536363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health