Provider Demographics
NPI:1528345683
Name:HAYES, TARA LEE (RN)
Entity type:Individual
Prefix:MRS
First Name:TARA
Middle Name:LEE
Last Name:HAYES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:TARA
Other - Middle Name:LEE
Other - Last Name:BATTISITI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:25 HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:FORT PLAIN
Mailing Address - State:NY
Mailing Address - Zip Code:13339-1365
Mailing Address - Country:US
Mailing Address - Phone:518-993-4000
Mailing Address - Fax:518-993-2897
Practice Address - Street 1:25 HIGH STREET
Practice Address - Street 2:
Practice Address - City:FORT PLAIN
Practice Address - State:NY
Practice Address - Zip Code:13339-1365
Practice Address - Country:US
Practice Address - Phone:518-993-4000
Practice Address - Fax:518-993-2897
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22-515765163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool