Individual
MRS. RENEE CHILDRESS HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
167 MOORE RD STE 206, KING, NC 27021-8770
(336) 673-6450
(336) 673-6449
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5006370
NC
363LF0000X
Family Nurse Practitioner
207Q00000X
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F06131209
AANP CERTIFICATION NUMBER
NC
Enumeration date
07/17/2013
Last updated
08/24/2022
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