Provider Demographics
NPI:1952942435
Name:HAYES, LATISHA BRITTANY (APRN)
Entity Type:Individual
Prefix:
First Name:LATISHA
Middle Name:BRITTANY
Last Name:HAYES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 COACHLIGHT DR
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-5601
Mailing Address - Country:US
Mailing Address - Phone:609-605-8509
Mailing Address - Fax:
Practice Address - Street 1:14 COACHLIGHT DR
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-5601
Practice Address - Country:US
Practice Address - Phone:609-605-8509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2019049123363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care