Shirley Haynes
Individual provider Active NPI Licensed Practical Nurse · Madison, FL
NPI 1972042018 · NPPES record last updated Feb 22, 2017
Key facts
- NPI
- 1972042018
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- PN961621 (FL)
- Practice address
- 219 SW Third Ave
Madison, FL 32340-2906 - Phone
- (850) 973-5000
- NPI assigned
- Feb 22, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN961621 | FL | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN961621 | FL | Yes |
Addresses
Primary practice location
219 SW Third Ave
Madison, FL 32340-2906
Mailing address
401 SE Bunker St Apt a
Madison, FL 32340-2906
Other providers in Madison, FL
- Kattrina Gonzalez
- Gracey & Mercy Medical Transport LLC
- Eric L Green
- Thomas Harvey Greene III
- Hawk Health Systems LLC
- Helping Hands of North Florida Services LLC
- Joseph Murray Herring
- Holiday CVS LLC
- Ella Aquilina Howard
- Rebecca Hughes
All providers in Madison, FL · Licensed Practical Nurse in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.