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Individual

KIRA MICHELLE HAYNIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP

Contact information

Practice address
150 N ROBERTSON BLVD STE 150, BEVERLY HILLS, CA 90211-2171
(310) 854-4995
Mailing address
1619 N LA BREA AVE APT 535, LOS ANGELES, CA 90028-6477
(856) 803-0734

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95021556
CA
363LG0600X
Gerontology Nurse Practitioner
95021556
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
95021556
NP LICENSE
CA
Enumeration date
10/31/2022
Last updated
10/31/2022
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