Individual
MARYBETH HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
14214 BALLANTYNE LAKE RD, STE 300, CHARLOTTE, NC 28277-3372
(704) 667-2600
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
300162
NC
Other
Enumeration date
07/26/2006
Last updated
01/13/2025
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