Individual
CHERYL HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2756 POST RD, SUITE 103, WARWICK, RI 02886-3003
(401) 384-6007
(401) 773-7878
Mailing address
4 ARCHER WAY, COVENTRY, RI 02816-4665
(401) 241-3324
(401) 773-7878
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN32050
RI
363L00000X
Nurse Practitioner
NP37125
RI
363LA2200X
Adult Health Nurse Practitioner
Primary
NPP37125
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000029629
RI BLUE CROSS PROVIDER #
RI
01
—
412667
RI BLUE CHIP PROVIDER #
RI
Enumeration date
01/25/2007
Last updated
11/02/2012
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