Basic Information
| Provider Information | |||||||||
| NPI: | 1578782330 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAYES | ||||||||
| FirstName: | CAROL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | P.A.-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 106 MCALPINE LN | ||||||||
| Address2: | |||||||||
| City: | LAURINBURG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283524637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102778044 | ||||||||
| FaxNumber: | 9102770036 | ||||||||
| Practice Location | |||||||||
| Address1: | 106 MCALPINE LN | ||||||||
| Address2: | |||||||||
| City: | LAURINBURG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283524637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102778044 | ||||||||
| FaxNumber: | 9102770036 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 102011 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | MEDICAID # FOR SCRIP | 01 | NC | ZA0000045 | OTHER | NCCPA | 01 | NC | 1029712 | OTHER | NC STATE LICENSES | 01 | NC | 102011 | OTHER |