Provider Demographics
NPI:1699975490
Name:HAYES, AMBER LEE (MD)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:LEE
Last Name:HAYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:LEE
Other - Last Name:WOLAK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2345 E PRATER WAY STE 207
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-9634
Mailing Address - Country:US
Mailing Address - Phone:775-352-5335
Mailing Address - Fax:775-352-5334
Practice Address - Street 1:5265 VISTA BLVD BLDG B
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-0836
Practice Address - Country:US
Practice Address - Phone:775-352-5335
Practice Address - Fax:775-352-5334
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV13689207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1699975490Medicaid
NV1699975490Medicaid
NVEO958XMedicare PIN
NVEO958YMedicare PIN
NVEO958VMedicare PIN