Jaclyn Joan Hayes, RN

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

R189659-8 Issued in MN

Practice address

22119 480TH Ave
Osage, MN 56570-9554

Phone

(218) 573-2238

Fax

(218) 573-3778

NPI assigned

Jan 30, 2013

Last updated

Jan 30, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Star Nursing Temporary Associates, Inc.

  • Home Health Agency
  • Osage, MN
  • NPI 1144345067
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1194063859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22119 480TH AVE",
            "address_2": "P.O. BOX 306",
            "city": "OSAGE",
            "state": "MN",
            "postal_code": "565709554",
            "telephone_number": "218-573-2238",
            "fax_number": "218-573-3778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22119 480TH AVE",
            "city": "OSAGE",
            "state": "MN",
            "postal_code": "565709554",
            "telephone_number": "218-573-2238",
            "fax_number": "218-573-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "JACLYN",
        "middle_name": "JOAN",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-30",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MN",
            "license": "R189659-8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylea Burlingame, LSW
• Lakeside Family Wellness LLC
• North Star Nursing Temporary Associates, Inc.

• Home Health Registered Nurse in Osage, MN
• Providers in Osage, MN by specialty
• Home Health Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.