Individual
MS. KELLY ALEEN HAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504
(928) 729-8000
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
(928) 729-8000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP4272
AZ
363LF0000X
Family Nurse Practitioner
AP60438941
WA
Other
Enumeration date
12/05/2011
Last updated
04/06/2020
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