Individual
JACQUELYN HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
80 MADDEX DR, SHEPHERDSTOWN, WV 25443-4305
(304) 876-9422
Mailing address
108 WEST GERMAN STREET, PO BOX 419, SHEPHERDSTOWN, WV 25443
(304) 279-2405
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
85112
WV
Other
Enumeration date
08/22/2014
Last updated
08/22/2014
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