| NPI | 1235329764 |
|---|---|
| Former Name | WANDA MARIE HAYNES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019040422) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 111047) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 726951) | |
| 363LF0000X Nurse Practitioner, Family (Licence: LA AP07135) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A-123907) | |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2023-12-11 |