Provider Demographics
NPI:1386954626
Name:HAYES, LACEY JAY (RN, MSN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:LACEY
Middle Name:JAY
Last Name:HAYES
Suffix:
Gender:F
Credentials:RN, MSN, FNP-C
Other - Prefix:
Other - First Name:LACEY
Other - Middle Name:JAY
Other - Last Name:MCCULLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:100 HITCHCOCK WAY
Mailing Address - Street 2:DARTMOUTH HITCHCOCK - ENDOCRINOLOGY
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-4125
Mailing Address - Country:US
Mailing Address - Phone:603-645-6401
Mailing Address - Fax:603-629-7727
Practice Address - Street 1:100 HITCHCOCK WAY
Practice Address - Street 2:DARTMOUTH HITCHCOCK - ENDOCRINOLOGY
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-4125
Practice Address - Country:US
Practice Address - Phone:603-645-6401
Practice Address - Fax:603-629-7727
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
NH069489-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No171M00000XOther Service ProvidersCase Manager/Care Coordinator