Individual
KATHLEEN C HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4539 WARREN MILL TRL, ELLENWOOD, GA 30294-2051
(678) 538-7151
Mailing address
4539 WARREN MILL TRL, ELLENWOOD, GA 30294-2051
(678) 538-7151
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN101149
GA
Other
Enumeration date
05/26/2012
Last updated
05/26/2012
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