Individual
MRS. THEADA C. HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2015 MARION ST, COLUMBIA, SC 29201-2113
(803) 898-0123
Mailing address
3113 JACKSON CREEK RD, WINNSBORO, SC 29180-7663
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R59025
SC
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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