Individual
MR. JUSTIN RAY HAYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
2500 W REYNOLDS ST, PONTIAC, IL 61764-9774
(815) 842-2828
(815) 842-4912
Mailing address
2500 W REYNOLDS ST, PONTIAC, IL 61764-9774
(815) 842-2828
(815) 842-4912
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-113420
AL
363L00000X
Nurse Practitioner
Primary
209018526
IL
Other
Enumeration date
07/23/2018
Last updated
12/13/2018
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