Individual
MS. TYNISHA HAILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1190 FILBERT HWY STE 110, YORK, SC 29745-9324
(803) 628-0004
Mailing address
1190 FILBERT HWY STE 110, YORK, SC 29745-9324
(803) 628-0004
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
25326
SC
363LF0000X
Family Nurse Practitioner
5009281
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295273936
—
NC
Enumeration date
02/02/2017
Last updated
10/01/2021
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