Individual
GEORGIA LEE HAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1 CONWAY CT, TROY, NY 12180-2108
(518) 274-6525
(518) 274-6511
Mailing address
24 SPRUCE ST, GLOVERSVILLE, NY 12078-4136
(518) 752-5555
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
275560-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
275560-1
RN
NY
01
—
82668-2
RN
FL
Enumeration date
01/23/2007
Last updated
06/01/2011
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