Individual
DR. KEITH BRYAN HAYNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, RN, CFNP
Contact information
Practice address
206 S CORONADO AVE, ESPANOLA, NM 87532-2792
(860) 788-6404
(860) 398-6441
Mailing address
PO BOX 1595, MIDDLETOWN, CT 06457-8095
(860) 788-6404
(860) 398-6441
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R45728
NM
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP01098
NM
Other
Enumeration date
12/17/2008
Last updated
04/30/2024
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