Provider Demographics
NPI:1962742049
Name:HAYSE, JOHNNA GIGI (FNP-C)
Entity type:Individual
Prefix:MS
First Name:JOHNNA
Middle Name:GIGI
Last Name:HAYSE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7494 N LA CHOLLA BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-2306
Mailing Address - Country:US
Mailing Address - Phone:520-395-0542
Mailing Address - Fax:520-505-4108
Practice Address - Street 1:7494 N LA CHOLLA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741
Practice Address - Country:US
Practice Address - Phone:520-395-0512
Practice Address - Fax:520-505-4108
Is Sole Proprietor?:No
Enumeration Date:2013-02-26
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ222971208VP0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ514328Medicaid