Individual
JOHNATHAN M HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNAP
Contact information
Practice address
1301 N RACE ST, GLASGOW, KY 42141-3454
(270) 651-4444
(270) 651-4892
Mailing address
1301 N RACE ST, GLASGOW, KY 42141-3454
(270) 651-4444
(270) 651-4892
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
211520
TN
367500000X
Certified Registered Nurse Anesthetist
28898
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
3015871
KY
Other
Enumeration date
12/04/2020
Last updated
10/31/2024
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