Individual
KIMBERLY LYNN HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
374 MAXEY RD, LONGVIEW, TX 75605-8247
(903) 452-3967
Mailing address
374 MAXEY RD, LONGVIEW, TX 75605-8247
(903) 452-3967
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
578162
TX
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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