Individual
DR. GRACE ANDREA HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4824 E BASELINE RD STE 140, MESA, AZ 85206-4680
(480) 969-4040
(480) 830-1042
Mailing address
4824 E BASELINE RD STE 140, MESA, AZ 85206-4680
(480) 969-4040
(480) 830-1042
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22571
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199895
—
AZ
Enumeration date
02/15/2007
Last updated
06/12/2018
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