Individual
REBECCA HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
80 PARKER DR, MONROE, GA 30656-4747
(678) 381-2630
(678) 381-2627
Mailing address
297 COOPER RD, LOGANVILLE, GA 30052-2518
(783) 812-6306
(678) 381-2627
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
209240
GA
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN-NP209240
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003191294B
—
GA
Enumeration date
06/12/2017
Last updated
10/14/2025
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