Provider Demographics
NPI:1689546939
Name:HAYES, SPARKEL LATERRICA
Entity type:Individual
Prefix:
First Name:SPARKEL
Middle Name:LATERRICA
Last Name:HAYES
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 1:256 SETTLERS PARK DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71115-3196
Mailing Address - Country:US
Mailing Address - Phone:318-294-8513
Mailing Address - Fax:
Practice Address - Street 1:256 SETTLERS PARK DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71115-3196
Practice Address - Country:US
Practice Address - Phone:318-294-8513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health