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Individual

TIA AUSTIN HAYES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
2500 N. STATE STREET, DIVISION OF NEPHROLOGY, JACKSON, MS 39216-4609
(601) 984-5687
(601) 984-5765
Mailing address
2500 N. STATE STREET, JACKSON, MS 39216-4609
(601) 815-6496

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R867941
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07127782
MS
05
140773
AL
01
P01750171
RAILROAD MEDICARE
MS
Enumeration date
07/08/2011
Last updated
07/18/2023
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