Individual
KATHERINE ANN HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
675 SOUTH 14TH STREET, COTTAGE GROVE, OR 97424-2776
(541) 914-1829
(541) 942-9022
Mailing address
675 SOUTH 14TH STREET, COTTAGE GROVE, OR 97424-2776
(541) 914-1829
(541) 942-9022
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
095000628RN
OR
163WC1500X
Community Health Registered Nurse
095000628RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500611115
—
OR
Enumeration date
09/23/2009
Last updated
02/25/2011
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