Provider Demographics
NPI:1447935796
Name:HAYES, KIERSTIN RENEE (NP)
Entity type:Individual
Prefix:
First Name:KIERSTIN
Middle Name:RENEE
Last Name:HAYES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KIERSTIN
Other - Middle Name:RENEE
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5353 FLORIDA BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-4130
Mailing Address - Country:US
Mailing Address - Phone:225-367-4558
Mailing Address - Fax:
Practice Address - Street 1:5353 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-4130
Practice Address - Country:US
Practice Address - Phone:225-367-4558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-15
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA229874363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily