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Individual

DEBRA L HAYES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
601 E FORT ST, FARMINGTON, IL 61531-1338
(309) 245-2406
(309) 649-6880
Mailing address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
(309) 649-5101

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
041150128
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0062839
UMWA
IL
01
02922981
BCBS
IL
01
035446
HEALTH ALLIANCE
IL
05
041150128
IL
01
1942315197
NPI CLINIC NUMBER
IL
01
200397
BLACK LUNG
IL
01
500011339
RR MEDICARE PIN
IL
01
CG5172
RR MEDICARE GROUP#
IL
01
IL0115
JOHN DEERE
IL
Enumeration date
08/28/2006
Last updated
04/18/2016
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