Provider Demographics
NPI:1891408712
Name:HAYES, JESSICA (FNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 GLADES RD STE 228W
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7391
Mailing Address - Country:US
Mailing Address - Phone:561-320-0996
Mailing Address - Fax:
Practice Address - Street 1:49 CLEVELAND ST STE 210
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-2854
Practice Address - Country:US
Practice Address - Phone:931-787-1477
Practice Address - Fax:931-787-1478
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30524363L00000X
HIAPRN-3615-0363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner