Provider Demographics
NPI:1124105895
Name:HAYS, JENNIFER MAYHEW (MPT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:MAYHEW
Last Name:HAYS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 WATERFORD WAY W
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1617
Mailing Address - Country:US
Mailing Address - Phone:804-405-7861
Mailing Address - Fax:
Practice Address - Street 1:10442 RIDGEFIELD PKWY
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-3544
Practice Address - Country:US
Practice Address - Phone:804-405-7861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305202425225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA140092OtherANTHEM
VA650000024Medicare PIN