MEDICARE: MRS. CHRISTINE BOTELER HAYNES R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	R045978	MD

General Provider Information

NPI Number	:	1720206410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINE BOTELER HAYNES R.N.

Provider Business Mailing Address
First Line	:	4913 DOWNLAND TER
Second Line	:
City	:	OLNEY
State	:	MD
Zip	:	20832-3109
Country	:	US
Telephone Number	:	301-774-3330
Fax Number	:

Provider Business Practice Location Address
First Line	:	7055 SAMUEL MORSE DR
Second Line	:	SUITE 200
City	:	COLUMBIA
State	:	MD
Zip	:	21046-3439
Country	:	US
Telephone Number	:	443-718-8036
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	04/04/2012

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