Individual
LISA COLETTE JENKINS-HAYNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
30 SHADY LN, WHITE STONE, VA 22578-2601
(804) 453-3133
(804) 453-1311
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101057965
VA
Other
Enumeration date
01/06/2006
Last updated
05/23/2019
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