Individual
MRS. LISA MICHELLE HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4700 PUDDLEDOCK RD, SUITE 400, PRINCE GEORGE, VA 23875-1237
(804) 458-1740
Mailing address
8001 FRANKLIN FARMS DR, SUITE 130, RICHMOND, VA 23229-5108
(804) 521-5800
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024170184
VA
Other
Enumeration date
07/17/2012
Last updated
09/05/2013
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