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Individual

MRS. MICHELLE MOORE HAYNIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NNP

Contact information

Practice address
1453 E.BERT KOUNS INDUSTRIAL LOOP, NICU WEST WING, SHREVEPORT, LA 71105
(318) 681-4316
Mailing address
333 JOHNS BLUFF CIR, SHREVEPORT, LA 71106-4733
(318) 426-5556

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP06220
LA
363LN0000X
Neonatal Nurse Practitioner
Primary
AP06220
LA
363LN0000X
Neonatal Nurse Practitioner
AP130435
TX
363LN0000X
Neonatal Nurse Practitioner
PA040129
LA

Other

Enumeration date
11/15/2011
Last updated
05/15/2023
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