Individual
REBECCA L HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
(260) 481-2838
Mailing address
11109 PARKVIEW PLAZA DRIVE MAILBOX 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
28161494A
IN
Other
Enumeration date
06/04/2017
Last updated
10/10/2022
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