Individual
MADISON EVA HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
37 GRANDE MEADOWS DR STE 203, BRIDGEPORT, WV 26330-9035
(304) 598-8900
Mailing address
236 MOUNT VERNON DR, HURRICANE, WV 25526-7253
(304) 421-9633
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
41533
WV
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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