Provider Demographics
NPI:1174243257
Name:FEWELL, HAYDEE BAEZA (RN)
Entity type:Individual
Prefix:
First Name:HAYDEE
Middle Name:BAEZA
Last Name:FEWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 PALOMINO CT
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2773
Mailing Address - Country:US
Mailing Address - Phone:913-704-8765
Mailing Address - Fax:
Practice Address - Street 1:4100 ALLEQUIPPA ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240
Practice Address - Country:US
Practice Address - Phone:412-822-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN742399163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical