Individual
ANDREA SHANA HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4101 WOOLWORTH AVE, OMAHA, NE 68105-1850
(402) 346-8800
Mailing address
305 DONAN ST, MOUND CITY, MO 64470-1601
(402) 917-7411
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
2005038768
MO
163WE0003X
Emergency Registered Nurse
R205129-3
MN
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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