Provider Demographics
NPI:1548918147
Name:HAYES, AMY MICHELLE (AGNP-C)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MICHELLE
Last Name:HAYES
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 HARMONY XING
Mailing Address - Street 2:
Mailing Address - City:EATONTON
Mailing Address - State:GA
Mailing Address - Zip Code:31024-9538
Mailing Address - Country:US
Mailing Address - Phone:706-485-4004
Mailing Address - Fax:706-262-2986
Practice Address - Street 1:119 HARMONY XING
Practice Address - Street 2:
Practice Address - City:EATONTON
Practice Address - State:GA
Practice Address - Zip Code:31024-9538
Practice Address - Country:US
Practice Address - Phone:706-485-4004
Practice Address - Fax:706-262-2986
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN185515363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner