Provider Demographics
NPI:1588289136
Name:HAYES, LAQUEASHA
Entity type:Individual
Prefix:
First Name:LAQUEASHA
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 WINCHESTER LN
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-9162
Mailing Address - Country:US
Mailing Address - Phone:319-541-0973
Mailing Address - Fax:
Practice Address - Street 1:1129 WINCHESTER LN
Practice Address - Street 2:
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-9162
Practice Address - Country:US
Practice Address - Phone:319-541-0973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver
No372600000XNursing Service Related ProvidersAdult Companion