Provider Demographics
NPI:1386342178
Name:HAYES, MICHELLE (RD, LDN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5461 WILDWOOD XING
Mailing Address - Street 2:
Mailing Address - City:PIPERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18947-1161
Mailing Address - Country:US
Mailing Address - Phone:215-570-5227
Mailing Address - Fax:
Practice Address - Street 1:5461 WILDWOOD XING
Practice Address - Street 2:
Practice Address - City:PIPERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18947-1161
Practice Address - Country:US
Practice Address - Phone:215-570-5227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN002286133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered