Individual
LISA HAYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
575 N RIVER ST, WILKES BARRE, PA 18764-0999
(570) 829-8111
(570) 208-5548
Mailing address
PO BOX 1676, KINGSTON, PA 18704-0676
(570) 208-5534
(507) 208-5556
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN520720L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00979472
RR MEDICARE
PA
Enumeration date
09/16/2010
Last updated
06/20/2012
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