Provider Demographics
NPI:1932578820
Name:HAYES, AMANDA LYN (WHNP)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:LYN
Last Name:HAYES
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:MISS
Other - First Name:AMANDA
Other - Middle Name:LYN
Other - Last Name:ADKINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP
Mailing Address - Street 1:3825 GILBERT DR STE 143
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71104-5000
Mailing Address - Country:US
Mailing Address - Phone:318-200-0020
Mailing Address - Fax:
Practice Address - Street 1:3825 GILBERT DR STE 143
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71104-5000
Practice Address - Country:US
Practice Address - Phone:318-200-0020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95292536363L00000X
LAAP08434363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner