Provider Demographics
NPI:1932906021
Name:HEREFORD, HAYLE
Entity type:Individual
Prefix:
First Name:HAYLE
Middle Name:
Last Name:HEREFORD
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 1:28949 GRACE LN
Mailing Address - Street 2:
Mailing Address - City:WALBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43465-9205
Mailing Address - Country:US
Mailing Address - Phone:567-315-7760
Mailing Address - Fax:
Practice Address - Street 1:28949 GRACE LN
Practice Address - Street 2:
Practice Address - City:WALBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43465-9205
Practice Address - Country:US
Practice Address - Phone:567-315-7760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No374U00000XNursing Service Related ProvidersHome Health Aide